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Cervical Degenerative Disc Disease  

Disc degeneration
Cervical disc degeneration is a common cause of neck pain, most frequently felt as a stiff neck. Cervical degenerative disc disease is much less common than disc degeneration in the lumbar spine because the neck generally is subjected to far less torque and force. Nonetheless, a fall, whiplash or a twisting injury to the disc space can spur degeneration, and accumulated wear and tear on the disc over time can also lead to neck pain caused by disc degeneration.

Cervical degenerative disc disease pain and symptoms
In addition to having the low-grade pain of a stiff or inflexible neck, many patients with cervical disc degeneration have numbness, tingling, or even weakness in the neck, arms, or shoulders as a result of nerves in the cervical area becoming irritated or pinched. For example, a pinched nerve root in the C6-C7 segment could result in weakness in the triceps and forearms, wrist drop and altered sensation in the middle fingers or fingertips.

Cervical disc degeneration can also contribute to spinal stenosis, and other progressive conditions, as well as a more sudden disc herniation.

Cervical degenerative disc disease diagnosis
Successful diagnosis of cervical degenerative disc disease begins with a physician reviewing the patient’s history of symptoms and performing a physical examination to measure neck extension and flexibility. During the exam, patients may be asked to perform certain movements and report whether the neck pain increases or decreases.

If a physical exam warrants further investigation, imaging studies such as X-Ray, MRI and possibly a CT scan will be taken. These diagnostic images can confirm whether and where degeneration is occurring, and can identify other conditions (such as calcification or arthritis) that could be causing the symptoms.

Cervical degenerative disc disease treatment
The general treatment is largely the same as for degenerative disc disease in the lumbar spine. That is, conservative care (no-surgical) is recommended as the primary strategy and surgery is only considered if a concerted effort at conservative care fails to provide adequate pain relief or a patient’s daily activity has been significantly compromised.

  • Chiropractic manipulation can relieve low back pain by taking pressure off sensitive nerves or tissue, increasing range of motion, restoring blood flow, reducing muscle tension, and, like more active exercise, promoting the release of endorphins within the body to act as natural painkillers
  • Over the counter and prescription medications may provide relief. These include non-steroidal anti-inflammatories (NSAIDs) and pain relievers like acetaminophen (such as Tylenol). Prescription medications such as oral steroids, muscle relaxants or narcotic pain medications may also be used.
  • Exercise, specifically stretching as many dimensions of the neck as possible,is essential to maintain flexibility in the neck and relieve chronic stiffness. A specific set of exercises should be developed by a physician or physical therapist. Some exercises that could be done several times a day include:
    • Chin-to-chest stretch, which stretches the back of the neck
    • Side-to-side swivel, which involves slowly turning the head to the left and right
    • Eyes-to-the-sky, where a patient lifts the chin upward to stretch the front of the neck and upper thoracic area
    • Ear-to-shoulder stretch to extend the sides of the neck as much as possible (this can be facilitated by gently placing a hand on the head but should not involve pulling or pushing the neck and head to the shoulder)
  • Use of a cervical pillows or neck traction may also be recommended to stabilize the neck and improve neck alignment so the disc compression is not exacerbated as a patient sleeps or relaxes at home

Surgery
If pain is not relieved adequately or daily activities become difficult, surgery may be considered.