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Back Out Of Whack? It May Be A Cervical Disc Herniation Says HSS Surgeon

Dr. Andrew Sama of HSS.
Dr. Andrew Sama of HSS. Photo Credit: Hospital for Special Surgery

STAMFORD, Conn. -- Dr. Andrew Sama, an orthopedic surgeon with Hospital for Special Surgery, answers questions on cervical disc herniations.

What are the best non-surgical or surgical options for a 41-year old male suffering from a cervical disc herniation? How long is recovery from both options?

Most non-surgical treatment options for cervical disc herniation center on decreasing inflammation and pain and maintaining or improving range of motion and stability.This usually includes physical therapy, massage, sometimes traction and anti-inflammatory medications or muscle relaxants.

If pain persists or if there is any weakness or progressive neurologic issue, surgery may be worth considering. Surgery is typically done through the front of the neck to decompress the nerves and fuse the spine segment in question. 

What are the ways to prevent cervical disc herniations?

We know that maintaining a general level of fitness, good cervical muscle tone and flexibility is good for overall spine health.

I’ve heard that stretches and exercise can make a cervical disc herniation worse, but I have also heard that remaining inactive is the worst thing you can do. What are your thoughts?

Aggressive stretching or manipulation of the neck can sometime cause herniations to worsen, and inactivity can make muscles stiff leading to increased pain. I usually recommend that patients maintain a good level of basic fitness, be mindful to strengthen their cores and avoid high-impact activities that may predispose them to cervical injuries.

Is surgery the only way to treat a cervical disc herniation?

No, in fact, most disc herniations are treated non-surgically with good results. Physical therapy, anti-inflammatory medications and time usually lead to improvement and the body can absorb the herniation. If there is progressive neurologic deterioration or persistent or worsening of pain, then we recommend surgery.

What is the most common cause of cervical disc herniation? 

Herniations can occur for a variety of reasons, some of which may be related to an accident or direct injury while others are less obvious and may simply result from daily activity.

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