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 Treatment for cervical
degenerative disc disease will usually be non-surgical. However if
conservative treatment fails, there may be a need for surgery. Surgery for
neck pain is much less reliable than surgery for arm pain, and should be
avoided if possible.
Conservative treatment
The conservative (non-surgical) treatment options are either passive (done
to the patient) or active (done by the patient). Usually a combination of
treatments will be used, as passive treatments are rarely effective on
their own—some active component is almost always required.
Common passive treatments include:
·
Medications. Over-the-counter pain
medicine such as acetaminophen (e.g. Tylenol) can help decrease pain and
can be used in conjunction with an anti-inflammatory medication such as
ibuprofen (e.g. Advil, Nuprin and Motrin).
·
Chiropractic/osteopathic manipulations.
These can be useful to relieve joint dysfunction that can be associated
with the pain. Manipulations work best when combined with an active
exercise program.
·
Epidural injections. Epidural
injections can be used to help decrease inflammation when there is severe
pain. The injection is done by inserting a needle into the space around the
thecal sac (epidural space) and then injecting a steroid medication. This
helps reduce inflammation in the spinal canal and can reduce pain in about
50% to 70% of patients. The injection should be used as part of
rehabilitation, as the pain relief can allow the patient to begin an
exercise and physical therapy program. If the injection works, but the pain
returns, it can be repeated up to three times in a 6-month period.
·
Trigger point injections. Tender
areas in the muscles can be injected with a small needle and lidocaine to
relieve muscular stress and tension, which should relieve the tenderness.
·
TENS units. Transcutaneous Electrical
Stimulation (TENS) units can be used to provide electrical stimulation to
the painful areas of the back. A low current electrical charge is
transmitted to the skin. Although the mechanism for how this relieves pain
is not exactly known, it has been proven effective for some patients and
allows them to function better with less medication. It is suspected that
the electrical signals help override the pain signals.
In addition, traction may be useful and a home traction unit may be
prescribed for use at home.
Common active treatments include:
- Physical therapy. Exercises and stretching
can be very helpful in strengthening and stabilizing the affected
area, thus reducing pain. It is very important, however, to work with
a professional health provider on the appropriate exercises as each
person responds differently, and what helps one person may actually
harm another.
- Quitting smoking. It has been proven that
there is a link between smoking and the ability for the spine to heal.
Since there is no benefit to smoking, quitting is highly advisable.
Surgical treatment
Rarely, a one (or possibly two) level fusion may be required to help
control symptoms and allow a patient to function more fully. This should
only be considered if non-surgical treatments have failed, and the pain the
patient is experiencing is severe enough to limit his or her activity level
or ability to function.
The goal of this surgery is to stop the motion at a painful motion
segment. A small metal plate or a bone graft is placed between the affected
vertebrae of the spine. As the bone fuses to the plate or graft, the spine
stabilizes in that area and reduces or eliminates the movement that was
causing pain.
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