There are 7 vertebrae in the neck and structures called discs between them and 2 small joints connecting both vertebrae. The disc material between the vertebrae consists of a relatively hard sheath on the outside and gel-like soft tissue parts on the inside, and its task is to evenly distribute the load on the vertebrae, to act as a shock absorber with a simple analogy. Another task of the disc and facet joints is to provide mobility of the neck in all directions. While weakening or tearing of the outer layer of the disc causes more neck pain, neck hernia, which can be defined as the outward displacement of the inner layer, creates pain especially on the shoulder and arm, as it puts pressure on the nerve root. In hernias that occur at the upper levels, the complaints occur in the shoulders, while in the hernias that occur in the lower levels, the complaints occur in the arms or hands in the form of weakness and numbness. Arm pain is often more severe when compared to neck pain, as it compresses the nerve roots. In advanced cases, weakness can go down to the legs.
Traffic accidents, overloading the neck muscles, desk work done by keeping the neck stable and inactivity are some of the causes of neck hernia. The first symptoms are neck pain and limitation of neck movements. Apart from neck pain, headache, shoulder pain and arm pain, even chest pain can be seen. Depending on how much pressure is on the nerves and the rate of deterioration of the discs, numbness in the arm, weakness in the arm and hand occur. The resulting neck hernia may compress the spinal cord and less likely cause problems in the legs and pathological reflex findings.
In the diagnosis of neck hernia, it is necessary to take a good history of the disease and perform an appropriate examination. After that, neck radiographs, Magnetic Resonance Imaging (MR) are used. In some cases, especially in elderly patients, computed tomography (CT) and direct radiography (X-ray) are required to better detect calcification in the vertebrae and/or the intervertebral region. If there is more than one neck hernia or if the nerves going to the arms are compressed, the nerve measurement test, which is an electrophysiological examination, namely EMG (electromyography) can also be performed.
Pain usually disappears spontaneously in patients with neck hernia. The pain, which is severe in the first week, decreases and disappears within four to six weeks. During this period, a short-term rest period, painkillers and muscle relaxants (nonsteroidal anti-inflammatory drugs reduce pain and edema in the nerve root, while muscle relaxants provide relief of neck muscle spasm) are often sufficient for some patients, physical therapy, exercise and neck pain relief. Injection applications to the area may be required. If these treatments are insufficient, surgical treatment may be required. Self-healing of the pain does not mean that the disease has disappeared. It is recommended that the patient protect his neck in order not to have the same pain attack again and do neck exercises to strengthen the muscles around the neck.
