I have a pinched nerve, I popped a disc!

Neck pain or arm pain due to compression and inflammation of spinal nerves or nerve roots of the cervical spine.

Most patients will complain of a deep, numb, or constant pain or an electrical shock pain along the arm. It is also common to present with pins and needles (paraesthesia).

The pain will mostly be at the level of the shoulder blade next to the spine or over the upper arm. It can also continue towards the hand. In more severe cases the patient will present with weakness of the hand or arm.

Sever causes of neck/arm pain include:
• Disc herniation (movement of cushion between vertebrae)
• Cervical spondylosis (age related wear and tear- osteoarthritis)

It is not okay to leave this pain to “hopefully go away”. To avoid permanent damage, we as a multidisciplinary team need to address the compression and inflammation of the nerve.

Physical manual therapy, NSAID’s (Non-Steroidal anti-inflammatory drugs) and exercise (prescribed by a professional) will improve or fix this problem.

Tips to help you at home:
• It is important to evaluate your posture and your daily activities
• Look at your pillow height. You want to use a firm thick pillow that keep your neck aligned with the spine.
• Sleeping on the tummy (prone) will cause rotation in your neck. This will “squash” the disc and the pain will be more intense
• Impact should be avoided for 6 weeks, e.g. running
• The pain will be aggravated with heavy lifting.
The recovery time after treatment will be in stages:
• Decrease in pain will take 6 weeks.
• Increased recovery between 4-6 months.
• Complete resolution within 24-36 months.

Imaging:
X-rays only show bony structures. The x-ray might show a decreased disc space or other signs of degenerative changes. An absence of pathology on the x-ray does not exclude a disc herniation.

An MRI (magnetic resonance imaging) is considered when conservative therapy is inadequate and findings should be interpreted in context with the patient’s presentation. 30-40% of young and middle-aged asymptomatic patients present with degenerative changes.

It is important to seek a multimodal approach to treatment, sooner than later.

Donné Conradie