Neurorehabilitation & Pain

Patient guides › Musculoskeletal pain

Cervical Disc Herniation: Specialist Summary

Medically reviewed by Prof. Dr. Engin Çakar, PM&R specialist · Updated

A cervical disc herniation occurs when a disc between the neck vertebrae presses on a nerve root or the spinal cord, which can cause pain, numbness or weakness in the neck, shoulder and arm. Symptoms from nerve root compression ease over time with non-surgical treatment in most patients. Signs of spinal cord compression (myelopathy), however, need separate and more careful assessment.

When to see a doctor

  • Neck pain spreading to the arm, with numbness or tingling in the hand
  • Pain not easing within a few weeks, or disturbing sleep
  • Emergency (red flags): clumsiness of the hands (e.g. difficulty with buttons), worsening walking and balance, leg weakness, change in bladder control; these may suggest spinal cord compression
  • Marked or increasing arm weakness; neck pain after trauma; pain with fever or weight loss

Treatment options

  • Conservative: patient education, ergonomic adjustments, appropriate medication
  • Physical medicine and rehabilitation: neck and upper back exercises, posture training and physical modalities when needed
  • Interventional pain treatment: image-guided nerve root or epidural injections in selected patients
  • Surgery: for myelopathy, progressive weakness, or severe arm pain persisting despite adequate conservative treatment

Surgery or not? When the decision is unclear, a detailed neurological examination, comparison of MRI with clinical findings and EMG assessment of nerve root involvement guide the way. EMG can also help distinguish conditions with similar symptoms, such as carpal tunnel syndrome. The decision is made with the patient, in collaboration between physical medicine and rehabilitation and neurosurgery.

Frequently asked questions

Can a cervical disc herniation cause dizziness? Dizziness has many causes; any link to the neck should be assessed by examination.

Should I wear a neck collar? Long-term use is generally not recommended; short-term use may be advised by your doctor.

Is my arm numbness from the neck or the wrist? Examination and, when needed, EMG help make this distinction.

Is surgery necessary? Not for most patients; it is considered when specific findings are present.

Sources

Turkish version: doktorfizik.com/rehber/boyun-fitigi/