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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
·
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
·
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:
1. 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.
2. 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.
3. 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.
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