What is neck hernia?
Neck hernia occurs after the cartilage tissue called the disc between the neck vertebrae is torn after a trauma or a force and leaves its place just like a toothpaste comes out of the tube and presses on the nerves (usually the nerves going to the arm and less often the spinal cord). is a disease.
The structures called discs between the vertebrae have a gel consistency in young people and are surrounded by hard connective tissue. After middle age, the gel-like disc loses its water content and starts to dry out. Thus, the structural deterioration of the disc and the process of herniated disc began. This elastic tissue, which loses its water, turns into a hard, easily torn tissue. With a trauma or force, the disc and the hard connective tissue around it are torn. The disc structure inside comes out from the torn wall and presses on the nerves in the spinal canal, causing symptoms such as pain, numbness and weakness
When should patients with neck pain be worried about neck hernia?
Neck pain or stiffness in the neck muscles can occur in many healthy people. Therefore, neck pain alone is not enough for us to suspect a cervical hernia. If neck pain is accompanied by shoulder, arm, forearm or hand pain, and especially if numbness or loss of strength in the fingers is added to this pain, we can say that there is most likely a neck hernia.
What can cause neck hernia?
Although a trauma or an excessive strain that forces the neck vertebrae causes this disease, the main reason is the weakness of the muscles around the spine. For example, in people with very strong muscles around the spine; Neck or lumbar hernia is not seen in weightlifters and wrestlers, as well as those whose profession requires heavy lifting. Because very strong muscles create support and resistance around the spine, preventing the disc from straining and tearing. In reality, the muscles around the spine are the person’s natural corset. The stronger and stronger this corset is, the more protected it is against spinal strain, heavy lifting or trauma.
Neck hernia usually occurs after people with weak neck muscles have an accident that complicates their neck vertebrae or after heavy lifting
Can it be familial?
Familial transmission of neck hernia has not been revealed yet. However, lumbar hernia and neck hernia can be seen frequently in some family members.
Does osteoporosis cause neck hernia?
Osteoporosis does not cause neck hernia. Osteoporosis is a disease that occurs with the loss of calcium (lime), which is completely related to the bone structure of the spine. Hernia is a disease of the cartilage structure called the disc, which is not related to the bone structure.
In which stage and what kind of complaints are seen in neck hernia?
In the first days of the event, severe neck pain and limitation of movement in the neck occur due to trauma or a force. In the advanced stages of the disease, severe pain radiating to the shoulder, elbow, wrist or the entire arm is present after the disc ruptures and leaves its location and presses on the nerves going to the arm. The severity of pain can be mild or unbearable, depending on the degree of compression of the nerve of the hernia. With the crushing of the nerve, numbness and weakness can be seen, especially in the forearm and hand fingers, apart from pain.
What are the methods used for diagnosis?
In diagnosing neck hernia in a person with arm pain, MRI is the most important examination that leads to a definitive diagnosis. EMG (Electromyography) is performed to detect the degree of nerve compression and to reveal the damage in the nerve. Even if there is no pain in patients with nerve damage detected in EMG, surgical treatment may be required. For this reason, EMG is important to make the operation decision in patients who have a large hernia but do not have pain in MRI.
Is drug therapy helpful?
In non-advanced hernias with low nerve pressure, lying down, applying heat to the neck and drug therapy are the first treatment methods to be tried. Antirheumatic pain relievers and muscle relaxants are used together as medicine. In the periods when the pain is severe, it should be continued in the form of pills after a few days of treatment in the form of injections. It is pointless to continue the medication after the pain disappears. As the pain recurs, medication can be taken from time to time.
Is massage, spa helpful?
Yes, massage is very helpful in reducing pain by solving muscle spasm that causes a significant part of pain. It will be very useful in antirheumatic gels applied to the skin while applying massage. It is relaxing in the spa, especially in chronic hernias associated with calcifications.
In which situations is a neck brace recommended?
The neck collar can be worn during the painful periods of the disease until the pain subsides (maximum 15 days). Long-term unnecessary use of the neck brace may cause the weak muscles to weaken further, thus causing the disease to progress.
How is physical therapy applied? Should it be repeated periodically?
It is applied as a second-line treatment in patients whose pain persists despite physical therapy, drug therapy and rest. Treatment can be provided in cases where the pressure on the nerve is not very severe. However, in cases of very advanced disease, physical therapy may not be beneficial. The patient, whose pain is relieved by physical therapy, should avoid situations that force the neck such as heavy lifting, reading a book or sewing with the neck bent forward, bending over the computer keyboard, and should follow the rules such as protection from the cold. Despite following these rules in daily life, the pain may recur from time to time, especially in cold and humid months. If necessary, physical therapy can be repeated during these painful periods.
In those with neck hernia, which drugs, which physical therapy and which ones are operated.
95 out of 100 patients with neck hernia are treated with non-surgical treatment methods. Antirheumatic pain relievers and muscle relaxants, heat application to the neck and lying down are recommended in initial hernias that have been exposed to pain for the first time, and the pain usually goes away with 1-2 weeks of rest, but some patients may need 4 weeks of rest for recovery. During this period, physical therapy should be considered in patients whose pain does not change. Physical therapy applied for 3 or 4 weeks will usually help patients get rid of pain. In some patients, despite the initiation of physical therapy, there may be no change in the severity of the pain and exacerbations may occur. These patients should not be able to insist on physical therapy and surgery should be performed as soon as possible.
Are injections to the neck, back and shoulder beneficial in neck hernias?
It is a method that is frequently applied in neck hernias with severe back, shoulder and arm pain, but it sometimes relieves the patient for a few months, sometimes for 3-5 days at the most. It is not a permanent treatment. It is not a very inconvenient method that increases calcification as it is thought, but it can provide relief for the patient for a short time.
How surgery is done.
With the method called myrodiscectomy, a 3 cm skin incision is made in the front of the neck and the cartilage tissue that is torn between the vertebrae and is displaced and presses on the nerves is removed. If the surgeon deems appropriate, some synthetic support tissues (such as cage, disc prosthesis) can be placed in place of this removed tissue.
Is there any deterioration in neck strength after surgical intervention?
No. When the patient comes out of the operation, his neck is as strong as before the operation.
At which stage of the disease does surgical intervention benefit? What are the chances of success?
Surgical intervention should be applied in severe pain that cannot be relieved by drug therapy, or in severe loss of strength and reflexes in the arm and hand. Neck hernia surgeries, contrary to popular belief, are operations that give very good results and are performed with low risks (below 1%). A very satisfactory result is obtained in 90% of patients.
Is physical therapy necessary after surgical treatment?
Normally, there is no need for physical therapy after neck hernia, but physical therapy to be applied after 1.5-2 months after surgery in hernias associated with severe calcification is quite beneficial.
Can recurrences occur after neck hernia operations?
Might have a 20% probability. Neck hernia may occur again when the patient strains his neck and neglects the exercises.
What are the exercises that the patient will do by himself? (If a diagram can be given, it will be more explanatory.)
Exercise should definitely be done in a pain-free period. Exercises performed while the pain is present can cause the pain to become more severe. Exercise movements are: First, do the movements that the neck can do in all directions, softly (bending forward-backward, tilting right-left, turning the head left and right) Also, do these movements in the form of pushing against a resistance. (For example, after placing your hand on your forehead, pushing your hand forward with your head, pushing the head back by placing the hand behind the head…)
Swimming is the most recommended sport for patients with neck hernia. Unconscious exercises done in gyms can cause neck hernia to progress and relapse of pain. For example, bodybuilding exercises by lifting heavy, sit-up movements are very inconvenient exercises for the neck.
Do orthopedic mattresses and pillows comfort the patient?
Orthopedic pillows allow the patient to relax while lying down, but they do not have therapeutic effects. If the patient can be comfortable on medium-height and medium-firm pillows (supporting the neck arch by filling it).
Can neck hernia be the cause of other complaints such as muscle weakness and humpback?
Progressive neck hernias can lead to weakness in the arm and leg muscles, thus inability to walk or falls. However, the hump is not visible.
What is your advice to people living with this disorder?
I can say that exercises are very important in patients with undeveloped hernia. Because the developed neck muscles are the person’s own corset. Thanks to the muscles strengthened with exercises, the pain will be less.
Secondly, carrying heavy loads by pulling the arm down (market shopping where many kilos of cargo is carried, carrying luggage, etc.) causes recurrent pain and progression of the disease.
Finally, exposure to cold and air conditioning while in a bath or sweaty causes relapses of pain without any heavy lifting. Patients with neck hernia need to protect their neck from the cold.
The more the cold is the cause of pain, the more effective it is in relieving the pain in the heat. For this reason, all kinds of heat (hot towel application, hot sand, sun bath, spa) will be useful in relieving pain in patients with neck hernia.
Neck snaps
Some patients have made it a habit. Some even state that they are relieved after the clipping. However, these sudden movements can cause strain on the neck joints and discs, and bruising of the joints and ligaments. Unfortunately, we cannot say that he was injured.
