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A cervical disc herniation can be a cause of pain that radiates down
the arm, sometimes accompanied by numbness and tingling down into
the fingertips, and sometimes muscle weakness as well. It usually
develops in men and women between 30 and 50 years old. This is one
of the most common cervical spine conditions treated by spine
specialists. The herniated disc may occur from an injury or trauma
to the spine, but it most commonly is a spontaneous development.
The arm pain occurs as a result of a disc in the cervical spine
(the neck) pinching or pressing on a nerve, which causes pain to
radiate down that nerve. Most cervical disc herniations extrude out
to the side of the spinal canal and pinch the exiting nerve root at
the next lower level of the spine.
Symptoms
Depending on which part of the cervical spine is affected, any of the
following may be symptoms of a cervical disc herniation:
-
Weakness in the deltoid muscle in the upper arm
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Weakness in the biceps (muscles in the front of the upper arms)
and wrist extensor muscles
-
Weakness in the triceps (muscles in the back of the upper arm and
extending to the forearm) and the finger extensor muscles
-
Weakness with handgrip
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Numbness and tingling along with pain can radiate to the thumb
side of the hand, down the triceps into the middle finger, or
down the arm to the little finger side of the hand
-
Shoulder pain
This list covers some of the typical symptoms,
but others may also occur. It is possible to have a cervical disc
herniation with symptoms completely different from these.
Discs in the cervical spine are usually not very large. However,
even a small disc herniation can pinch the nerve and cause pain. The
pain is usually greatest when the nerve is first pinched.
Diagnosis
Since the symptoms vary widely, often, the best way to correctly
diagnose a cervical disc herniation is with a diagnostic imaging
test such as the following:
- MRI Scan
The best test to use is an MRI (Magnetic Resonance Imaging)
scan. An MRI scan can usually see any nerve root pinching caused by
a herniated cervical disc.
- CT Scan with Myelogram
A CT (computed tomography) scan with myelogram may also be
ordered, because it is more sensitive than the MRI and can see
subtle pinching that might be hard to see on an MRI. This test is
not usually the first one ordered because an injection is required
to place an imaging dye into the patient. Therefore, it is best to
try an MRI first in order to see if that will be enough. CT scans
without myelogram will not do much good for diagnosing this
condition so are not used.
- EMG
Occasionally, an EMG (Electromyography) may also be used. This
is an electrical test that stimulates specific nerves to see if
certain muscles may have been affected from a pinched nerve, which
could indicate cervical disc herniation.
(Continued on next
page.)
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