Head & Neck Injuries/Conditions - Disc bulge/Hernatied disc in neck

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Disc bulge/Hernatied disc in neck

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Forum Name: Head & Neck Injuries/Conditions
Forum Description: Patients can post questions and experiences about head & neck injuries/conditions.
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Topic: Disc bulge/Hernatied disc in neck

Posted By: Ask a PT
Subject: Disc bulge/Hernatied disc in neck
Date Posted: Jun 27 2010 at 12:26pm

Our user asked: "Quick question can 2 bulges in neck and Herniated disc in c5-c6 cause These symptoms, NO PAIN, BUT PRESSURE ON EYES, AND TEMPLE AREAS, EVEN GET LIGHTHEADED WHEN I RUN, OR DO SOMETHING STRENUOUS WITH MY NECK, BUT NO PAIN IN AREA???? WHEN I DO SHOULDER PRESSES, OR RUN, I TEND TO GET THESE Symptoms AS WELL?? Just curious?? I ASSUME its good to not do these strenuous activities for a while to let the herniated and bulges in disc heal?? But do neck exercises to strengthen area?"

Ask a PT Response: "Pressure at the eyes and temple areas with cervical disc involvement could be a symptom. However, since you are not experiencing any pain and only experience symptoms when you are performing strenuous activities such as running and shoulder presses, there might be other contributing factors to your condition. I'd recommend you seek further medical attention to address your condition. I would make sure you are cleared for anything that has to do with the cardiovascular system as well."

Replies:

Posted By: patshe
Date Posted: Aug 10 2010 at 7:31pm

new to this forum, hoping this is proper procedure for posting a question.

i just received mri results: C6-7 paracentral disc protrusion with moderate left

sided neural foraminal encroachment related to left lateral bulging of disc;

bulging disc and osteophyte formation at C3-4, C4-5, and C5-6 with neural

foraminal encroachment primarily related to osteophytes at these levels.

unsure what activities I should be doing and what not to do, also no mention

of degenerative, and have no history of neck injury, wondering how

this condition came about. i'm 50 y.o., which is just months beyond

my forties so hard to believe this is age. i do alot of book work and

computer work...ideas?

please reply to mailto:plink0424@yahoo.com - plink0424@yahoo.com

thanks

Posted By: Ask a PT
Date Posted: Aug 14 2010 at 8:46pm

Hi Patshe,

Onset of your condition could be due to multiple variables ie. age (as you get old older it is not uncommon for the discs to lose its substance and degenerate or to develop osteophytes), genetics, prior injuries, occupation, posture, etc..

One thing to definitely consider given your condition is to perform an ergonomic examination at your office space to minimize strain/stress on your neck/discs ie. height of chair, back support for chair, proper level for monitor etc. Patients with this condtion are advised to avoid high impact or higer level activities which could exacerbate the condition. If you have not seen a physical therapist, it may be a good idea to see one so that he or she can conduct an evaluation and develop a plan of care based on your specific findings and needs.

Posted By: maris
Date Posted: May 18 2011 at 9:02am

My husband has been suffering for neck pain since Feb. 2011. Was asked to take an MRI exam by an ortho doctor. Result of an MRI was stated below. Was advised by his surgeon to do surgery. At present we are now having sessions with PTs for neck & lumbar traction and massages. We do not consider surgery at this time. I would like to ask for your opinion if we could still cure this thru conservative treatment. Please see below for your reference. I would gladly appreciate hearing for your advise on how to improve his situation / relieve him from pain . Thank you in advance.

MRI – CERVICAL

1. LARGE DISC PROTRUSION LEFT PARACENTRAL COMPRESSING THE LEFT NERVE

ROOT AS WELL AS INDENTING THE VENTRAL THECAL SAC AND CORD AT C5-6 LEVEL

2. POSTERIOR DISC BULGES WITH CENTRAL DISC ANNULAR FISSURE FORMATION

AT C3-4, C4-5 AND C-7 LEVELS

3. CENTRAL DSISC ANNULAR FISSURE FORMATIONS ARE NOTED AT THE C6,7, C4-5 , AND C3-4 LEVELS.

4. STRAIGHTENING OF THE CERVICAL SPINAL CURVATURE IS NOTED

5. THERE IS A DIMINUTION OF THE VERTICAL DIMENSION OF THE C5, C6, & C7 AND T1 VERTEBRAE

6. THE SPINAL CANAL AND EXIT FORAMINA ARE NARROWED

7. THE LIGAMENTUM FLAVUM AND POSTERIOR LONGITUDINAL LIGAMENTS ARE NOT HYPERTROPHIC

8. THE REST OF THE INTERVERTEBRAL DISC VERTEBRAE BODIES , PEDICLES, TRANSVERSE AND SPINOUSPROCESSES, ATLANTOOCCIPITAL, ATLANTOAXIAL, UNCOVERTEBRAL AND FACET JOINTS ARE UNREMARKABLE.

9. THER ISNO EVIDENT COMPRESSION DEFORMITY NOR SPONDYLOLISTHESIS

10. THE PRE AND PARASPINAL SOFT TISSUES ARE UNREMARKABLE.

MRI – LUMBOSACRAL SPINE

1. LUMBOSACRAL SPINE IN MULTIPLANAR VIEWS WITH CONTRAST GD. DPTA INJECTION DEMONSTRATES SCHMORL’S NODE FORMATION AT L5,L4,L3 AND L2 VERTEBRAE

2. THERE IS A SLIGHT DIMINUTION OF THE VERTICAL DIMENSION OF THE L5,L4 AND L3 VERTEBRAE

3. THE CONUS MEDULLARIS , CAUDAL ROOTS AND DISTAL CAUDAL SAC ARE INTACT

4. THE SPINAL CANAL INCLUDING THE LATERAL RECESSES AND EXIT FORAMINA ARE NOT NARROWED

5. THE LIGAMENTUM FLAFUM IS NOT HYPERTHROPHIC

6. THE REST OF THE INTERBERTEBRAL DISCS, VERTEBRAL BODIES, PEDICLES LAMINAE , TRANSVERSE AND SPINOUS PROCESSES AND FACETS JOINTS ARE UNREMARKABLE

7. THER IS NO EVIDENT SPONDYLOLISTHESIS

8. THE PRE AND PARASPINAL SOFT TISSUES ARE UNREMAKABLE

Posted By: Ask a PT
Date Posted: May 18 2011 at 12:54pm

Hi Maris,

How has your husband been tolerating physical therapy so far. Has he been able to obtain some relief from his pain? If physical therapy is effective, it probably makes sense to avoid surgery.

Looks like from the MRI of your husband's neck, he has a lot going on and it doesn't look the greatest. With the severity of the disc protrusion and the other factors described, therapy may not be effective and other alternatives may need to be considered.

His lumbar spine, on the other hand, doesn't appear to be as bad compared to the cervical spine and therapy may prove more effective.

Either way, I always believe trying more conservative treatment options, if available, is a more wise choice prior to opting for surgery.

Posted By: maris
Date Posted: May 19 2011 at 8:00am

Thank you for your prompt reply... He's been seeing his theraphist every other day but no improvement so far. The pain is beginning to be more and more painful that's why we are now being confused. We diligently follows the exercises they taught us plus the vitamins and medicines they gave us , but still no success. I am so worried coz he's beginning to suffer depression due to his condition. His drive that we will be able to overcome this challenge in our life is beginning to crumble. Do you have any ideas if when is the time that we should really consider the surgery? At present numbness in his back and shoulder are always there. As much as possible we are avoiding pain reliever drugs since somebody told us that if we always took this kind of drug; he will get immune to it later. Have you encountered this kind of case , who was cured as time goes by. Do we still have a hope that everythings gonna be fine. Need your honest opinion.

Please you might have some suggestion or other treatment in mind that we can try. Thank you so much for your concern.

Maris

Posted By: Ask a PT
Date Posted: May 19 2011 at 8:45am

How long has he been in therapy for now? I usually give it 2-3 wks of therapy for my patients who have conditions similiar to this to determine the next step. If there is no marked improvement or if the condition worsens, I would refer them back to the neurosurgeon. Given what the MRI reveals of your husband's neck, the prognosis is not the greatest for outcomes with physical therapy or medications. Consideration should be taken to avoid further irritation and damage to the nerve which could result in nerve damage and loss of sensation, strength, function, muscle atrophy, etc. Probably best to have further discussion with the therapist he is seeing to get his or her input as the therapist has been working with your husband and will be able to give you a better prognosis. I wish your husband and yourself the best of luck for his recovery.

Posted By: maris
Date Posted: May 19 2011 at 10:14am

Hi! We are enrolled in the theraphy session for 2 months now... and so far no improvement at all. We consulted another doctor but also recommended surgery. We have read somewhere that disc protrusion may heal in time thru proper care and medication. the possibility that swellnes might shrink and heal the disc by natural healing. Have you heard of this? Do you any idea on this? We are still hoping that somehow God will hear our prayers and he will be healed. This is the only thing that give us strength and courage. Hope that we will overcome this challenge in our life. Thank you so much and please pray for us.

maris

Posted By: Ask a PT
Date Posted: May 24 2011 at 1:27pm

Hi Maris - I did say a prayer for your husband in church this past Sunday. I am sorry to hear that it has been 2 months now of therapy with no significant improvement for your husband's condition. I think your husband and yourself should have further conversation with his PT, as I feel 2 months is more than enough time to determine if PT will be effective or not. Again, given what you have described to me of your husband's condition, I don't feel conservative treatment such as PT will be effective for his neck. Surgery may result in more effective outcomes and interdisciplinary discussion should occur between your husband's PT and surgeon.