The cervical portion of our spine is like an extended wrist to a hand holding a bowling ball. Imagine trying to balance a bowling ball into various necessary twists and turns while going about the activities of your life. The supportive muscle groups, tendons and ligaments are extremely important. They work to hold a joint firmly together. The joint has a small, doughnut-shaped, shock absorber inside it, between the bones. We call it a disc. It is identified by it’s location. For example, the disc between your 3rd and 4th neck bone (vertebrae) is called your C3-4 disc.
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The intricate working of your spine permits a wide range of motion (ROM) of the head in relation to the trunk. A degree of stability and flexibility is required to control the motion and dissipate the forces applied to the spine.
Everyone knows that a sudden unexpected movement, particularly those that involve lateral flexion and rotation of the head and neck with the neck in a protruded position (a whiplash) of the head moving in one direction as the torso remains in the other can cause significant and immediate pain and headache.
What few know is that cervical discogenic pain can just as frequently be caused by a work condition in which one must endure prolonged sitting without proper ergonomics.
Unfortunately, once the connective tissues in the neck are damaged in a sprain/strain incident, the breakdown in the support mechanisms can progress to the point that they cause even more serious conditions to develop. For example, ligament instability causes the irregular articulation of the vertebrae and the discs between them which in turn causes a degenerative condition that can result in serious and permanent conditions such as vertebrae spurring and disc disorders such as desiccation, bulging, and even herniation.
A ruptured or herniated cervical disc is a common cause of neck, shoulder and arm pain. Symptoms may include dull or sharp pain in the neck or between the shoulder blades, pain that radiates down the arm to the hand or fingers, or numbness or tingling in the shoulder or arm. Certain positions or movements of the neck can intensify the pain.
The symptoms of a cervical herniated disc often resemble other disorders such as carpal tunnel syndrome or problems with the rotator cuff. In some patients, a cervical herniated disc can cause spinal cord compression where disc material pushes on the spinal cord. This is a much more serious condition and may require a more aggressive treatment plan. Spinal cord compression symptoms include difficulty with fine motor skills in the hands and arms, and tingling or “shock” type feelings down the shoulder and into the arms.
Unfortunately, many doctors will suggest that you simply rest and medicate and the problem will often go away. While this is true is some occasions, it may not be in yours.
A typical second step of treatment is referral to a physical therapy. This may do well in keeping the soft tissue damage from scarring in such a way as to reduce future range of motion, but it doesn’t help a disc that may already be herniated. We probably won’t know if you have a herniated disc until you have an MRI – and then, some of those images can be misleading.
If you’ve previously had a cervical surgery , such as a “fusion” or “laminectomy”, it is common that your pre-existing condition makes you more susceptible; an impact or strain/sprain can much more damage to you then to someone who does not already possess a weakened condition.
If the employer’s doctor says your current injury is not related to your job now and the Office of Workers Compensation won’t approve of this surgery, you should seek another opinion. Putting off treatment and surgery, if necessary, can result in years of unnecessary pain and disability.
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