Treatment is designed to resolve the pain initially, and the weakness, numbness and tingling will go away over time. Once the pain starts to improve it doesn't usually return. It may be a little while before the other symptoms go away, but if the pain is under control there is no reason to move to a more aggressive (surgical) treatment, as there is no evidence that surgery helps the nerve root heal any faster. However, for patients with profound weakness due to a disc herniation, it may be reasonable to consider surgery earlier to give the nerve the best healing position (e.g. to relieve the pinching).

Conservative treatments
Generally, treatment will begin very simply with rest and medication. Anti-inflammatory medications such as ibuprofen (e.g. Advil, Nuprin or Motrin) or COX-2 inhibitors (e.g. Bextra or Celebrex) can help reduce the inflammation of the disc material, which will help reduce the amount of pain. If pain is severe, or continues for more than two weeks, stronger medication such as oral steroids may be considered.

While the medications diminish the amount of pain, if the condition doesn't resolve on its own, there are several options that can be considered:

• Physical therapy for exercises to help relieve the pressure on the nerve root
• Chiropracticor osteopathic treatments for gentle, low velocity manual manipulation to help relieve the pressure on the nerve root. However caution should be used with manipulation if the patient is experiencing any neurological problems.
• Manual traction to help open up the cervical foramen where the nerve root exits the spinal canal. If this therapy helps relieve the pain, a home traction unit can be prescribed. Traction should be initiated under a physical therapist's supervision.
• Epidural injections may be considered if the pain doesn't get better with medication and physical treatments. Epidural injections effectively relieve pain approximately 50% of the time, and if they do work they may be repeated every two weeks up to a total of three times within one year.

• Cervical herniated disc symptoms and treatment options • Conservative treatment for a cervical herniated disc • Spine surgery for a cervical herniated disc

Surgical treatments
Most episodes of pain from cervical disc herniation will be taken care of with 6 to 12 weeks of conservative treatment. However, if it doesn't get better in that time or if the pain is very severe, surgery may be considered. The success rate for using surgery to relieve arm pain from a cervical disc herniation is about 95 to 98%. Risk of complication is low with an experienced spine surgeon.

The disc may be removed from the back of the neck (posterior approach) or from the front (anterior approach). Generally, surgeons prefer the anterior approach for most cervical disc herniations.

• Anterior approach—This approach may be favored if there is any disc space collapse, as the approach allows the surgeon to open up the disc space and place a bone graft to keep it open. This procedure opens up the foramen, which gives the exiting nerve root more room.
• Posterior approach—This approach may be favored for a large soft disc that is lateral (to the side of) the canal. This approach is technically more difficult than the anterior approach, and also requires more manipulation to the spinal cord.