Active Care Rehab

Cervical Disc and Neck Pain

This week we are going to discuss the cervical (neck) disc herniations. The cervical spine or neck consists of seven vertebrae and five disc which allow the spine to be flexible.

When the discs (much like the Lumbar Spine) become irritated they can begin to migrate posterior or backwards and cause pain. When the disc migrates it can become a bulge or herniation.

A herniated disc usually is caused by wear and tear of the disc. Today, we speed this process up due to postures such as rolled shoulders and forward head posture. These positions place a large load on the lower neck and place the disc under increased pressure.  Herniated discs are much more common in people who smoke, Cervical or Lumbar.

Herniated discs in the neck can cause pain, numbness, or weakness in the neck, shoulders, chest, arms, and hands. Early signs are pain in the neck, shoulder and shoulder blade. It is often described as sharp, deep pain that massage can not get to. On the other hand, many people experience no symptoms from a herniated disk. Most people who have a herniated disk don’t need surgery to correct the problem. According to Mayo Clinic, 90% of disc injuries resolve with conservative treatment.

Conservative Treatment for cervical disc injury or irritation consists of a combination of corrective exercise, posture restoration, and myofascial release. Releasing the tissues in the neck with Active Release or Graston can take strain off of the disc and allow the rehab exercises to be more effective. Since a disc injury involves inflammation, anti-inflammatory nutrition may help reduce the pain while undergoing treatment. Cervical Neck Traction and Treat Your Own Neck 5th Ed (803-5) can be helpful as well.

Classic Seated Posture
Classic Seated Posture

Forward head posture (FHP) has almost become the norm in society today. This occurs when sitting with poor posture for long periods of time. FHP leads to a reduction in the normal curve of the neck and muscle imbalance. When these changes occur the posture is visible when standing or walking as well.

When the normal curve of the neck straightens, the upper back compensates by rounding and becoming stiff. This places increased stress and load on the lower cervical spine. The disc and ligaments can become overworked and leads to pain. Increased stress on these ligaments and disc can start to weaken their collagen fibers and allow the posterior or backwards migration of the disc material.

When the head protrudes forward the muscles in the back of the neck become tight and when this condition is chronic scar tissue can develop. The muscles in the front become stretched and start to weaken. This is why most individuals with FHP can not touch their chin to their chest. So if you are dealing with disc-like symptoms or FHP the exercises here may be beneficial to you.

Yours in health,

Dr. Justin Hildebrand

Active Care Rehab

Lumbar Disc Injury Prevention

The low back consist of five lumbar vertebrae and the sacrum or “tail” bone. Between these vertebrae are discs that act as ligaments and allow the spine to be flexible. A disc is a little like a jelly donut, with a softer center encased within a tougher exterior. When the discs become irritate they can begin to migrate posterior or backwards and cause pain. When the disc migrates it can become a bulge or herniation.

Many factors play a role in disc herniation. The most common are flat-back posture (plumber’s crack), prolonged sitting, working in a slumped position, and incorrect lifting/bending posture. All of these factors place increased pressure on the disc and can lead to irritation and possible herniation.

The symptoms of disc irritation or herniation are pain in the low back, buttock or hip (most common) and radiating pain down one leg. Pain is generally worse in the morning and subsides with movement, increases with sitting or driving, and is irritated with changing of position such as sitting to a standing and rolling over in bed.

According to the Mayo Clinic “Conservative treatment… relieves symptoms in nine out of 10 people with a herniated disk. Many people get better in a mo

nth or two with conservative treatment.” Treatments consist of correcting seated posture, adjusting activities of daily living, corrective exercise, and treating dysfunctions with manipulation, Active Release, and anti-inflammatory nutrition.

The classic disc presents with the symptoms: pain in the low back and/or buttocks area that may or may not travel down one leg. The pain is generally in the SI joint or back of the hip. It will increase with sitting or being slumped over.

The disc patient generally has a flat low back and tight posterior muscles. The hamstrings are tight so the patient can not generally bend down and touch their toes easily and the “piriformis” muscles are tight so sitting in a cross legged position is not comfortable. This presentation generally looks as if the back is rounded and the buttocks is clinched while standing.

Most disc presentations state “I just bent over to pick something up and had pain in my back.” Repetitive flexion (bending) or rotation movements set up the low back for injury.

So if you are dealing with disc-like symptoms click here to see rehab exercises.

Yours in health,

Dr. Justin Hildebrand