Physiotherapy in cervical disc prolapse

The normal intervertebral disc is composed of a nucleus pulposus, at the center, surrounded by a fibrous ring known as annulus fibrosis. Cervical disc herniation is a condition in which the inner gelatinous substance of the disc escapes through a tear in the outer, fibrous ring causing a compression of the spinal cord or the surrounding nerves, resulting in neck or arm pain. Herniated disc is also known as a bulging disc, ruptured disc or slipped disc. This condition tends to be most prevalent in the 30-50 age group and is rare outside this group. The discs consist of a tough outer fibrous layer that surrounds a gel-like nucleus. Repeated stress and overuse during neck movements, for example in machine operators and keyboard users, can lead to degeneration of the outer layer of the disc. If this degeneration is sufficient the nucleus material is liable to ‘prolapse’ out of the disc.

Causes

• Aging related wear and tear.
• Traumatic accident such as fall.

Symptoms

• Patients with a slipped disc in the neck will experience severe pain, which can be present in the neck, shoulder and down the arm. This pain can be exacerbated by neck movements and even by coughing or sneezing.
• Muscle spasm in the neck.
• Pins and needles, numbness or burning may also be felt radiating down the arm.
• Neck pain and or arm pain with muscle weakness in the arm.

Physiotherapy interventions

Physical therapy often plays a major role in herniated disc recovery. Involving below key points

• Exercise
• Pain control.
• Education and maintaining healthy lifestyle.

Physiotherapy programs are often recommended for the treatment of pain and restoration of functional and neurological deficits associated with symptomatic disc herniation. This programs and modalities used in the treatment includes:

• Stretching
• Muscle strengthening
• Manual therapy and mobilization
• Mechanic traction
• Hot and cold therapies.
• Ultrasound therapy.

Some key point in prevention of Cervical disc prolapse.

• Proper lifting techniques (see Self Care for Neck & Back Pain)
• Good posture during sitting, standing, moving, and sleeping.
• Appropriate exercise program to strengthen weak abdominal muscles and prevent re-injury.
• An ergonomic work area.
• Healthy weight and lean body mass.
• A positive attitude and stress management.
• No smoking.