What is Cervical Hernia?
Cervical hernia is when the discs that act as shock absorbers in the cervical vertebrae put pressure on
the spinal cord and the nerves that separate from the spinal cord, due to which
they wear out, tear or slip due to various reasons.
The human spine is a dynamic structure consisting
of 33 vertebrae. The neck and waist are the most mobile areas of the spine. It
is located between the vertebrae, which are the bone structures that make up
the spine, and provides the connection between them. The discs act as shock
absorbers for pressure and loading.
What are the Causes of Cervical
Hernia?
The fluid content inside the discs located between
the vertebrae decreases over time and with age. Misuse of the spine also
increases this reduction. As a result, the drive's durability against loads is
reduced. Difficulties in the form of making uncontrolled sudden movements,
working at the desk and in a fixed state for a long time, doing jobs and sports
that put a load on the spine or require continuous rotational movements,
falling from a height and being exposed to traumas such as traffic accidents
can cause disc tears and cause cervical hernia.
Although cervical hernia is seen in all age groups, it is generally more common in the young-middle
age group. In addition, smoking is a risk factor for cervical hernia as well as
herniated disc. Working at a desk for a long time, driving for long periods of
time, leading a sedentary life, using inappropriate pillows during sleep,
engaging in movements and activities that force the spine and doing
inappropriate sports activities are other risk factors for cervical hernia. The
fact that the muscles around the neck are powerless also increases the load on
the discs and prepares the ground for herniation.
What are the Symptoms of Cervical
Hernia?
The most common and
earliest symptom of cervical hernia is pain in the neck area. Not every neck
pain is due to a cervical hernia. Muscle-induced pain is actually quite common
in the neck area. Pain due to hernia is both more resistant and shows some
features. The pain may spread unilaterally from the neck to the arm or may
spread to the back or from the neck to the head. Although the pain is usually
of a continuous character, it tends to be exacerbated by neck movements. In
addition to pain, complaints such as numbness in the arms and hands, tingling,
burning, needling and electric shock can also be added to the table. In
addition, neurological symptoms such as loss of sensation, decreased strength,
decrease in hand skills and thinning of the arm can also be seen. Coughing,
sneezing and straining can increase pain.
How is cervical hernia diagnosed?
The diagnosis of cervical hernia is made by physical and neurological examination as well as a
careful patient history. Imaging methods such as X-rays, MRI (magnetic
resonance) or CT (computed tomography) help to confirm the diagnosis and create
the treatment plan. In some cases, nerve examinations called EMGs
(electromyography) may be needed.
Pain in the neck, back, shoulder and arm area can
also be caused by diseases other than cervical hernia. Sometimes pain reflected
from internal organs can cause similar signs and symptoms. Therefore, before
making the diagnosis of cervical hernia, it is necessary to exclude these
ailments that may cause similar complaints. For this purpose, if deemed
necessary, further imaging and laboratory examinations can be applied.
How is Cervical Hernia Treated?
A very large
proportion of cervical hernia patients can be treated without the need for
surgical intervention. In some mild cases, improvement in complaints can be
achieved by resting, regulating activities of daily living and educating the
patient about the correct use of the neck. These patients should be directed to
a regular exercise program and followed-up.
Painkillers and muscle relaxant drug treatments are
often applied to treat cervical hernia. Again, drugs containing
corticosteroids can be used under the supervision of a doctor if needed. In
some cases, it may be necessary to use a neck brace temporarily.
Physical therapy methods are used in cervical
hernia patients who cannot get results with these treatments and measures or
who present with severe nerve pressure. For this purpose, hot applications,
ultrasound, laser, painkillers and muscle strengthening flow treatments,
massage, mobilization, manual therapy, hiltherapy (high-intensity laser
treatment), dry needling, taping, traction (classical and vertical
traction-vertetrac) are the most commonly used treatment methods.
As complementary and supportive treatment methods,
acupuncture, neural therapy, cupping therapy and ozone therapy can also be used to treat cervical hernia.
Spinal decompression therapy is an effective
treatment method in the treatment of cervical hernia as well as herniated disc.
It is based on the application of controlled traction to create negative
pressure at the level of the affected disc.
In some cases, epidural injections and nerve blocks
may be given to the neck area to relieve pain. Trigger point injections can
also be applied to the neck, back and shoulder muscles.
Exercise therapy should be an integral part of
treatment in the treatment of cervical hernia. First of all, the patient is
trained on the correct use of the spine and activities of daily living. Then an
exercise program is started that includes stretching, stretching, strengthening
and posture exercises. The intensity and duration of this program is determined
according to the clinical condition of the patient.
Clinical Pilates applications are a very useful
treatment method in both treatment and prevention in cervical hernias as well
as in other spinal problems.
Surgical treatment is rarely needed in the treatment
of cervical hernia. Surgery is used as the last
treatment option in patients who do not benefit from non-surgical treatments
and who have severe and progressive neurological losses.