Disc protrusion of the cervical spine

General

The human spine consists of the bony vertebral bodies with a portion of cartilage that are connected by joints. The intervertebral discs act as "buffers" between the individual vertebral bodies. These are found in the entire area of ​​the spine, from the neck to the thoracic to the lumbar vertebrae.

Intervertebral discs consist of one Fiber ring (Anulus fibrosus), of an inner Gelatinous core (Nucleus pulposus) surrounds. The gelatinous core absorbs shocks and violent movements so that the vertebral bodies do not rub against each other.

For various reasons, this inner gelatinous core can be squeezed out of the fiber ring. That can happen when the Fiber ring loses its stability and elasticity and cracks. The core can then no longer be held in the middle and bulges in the direction of the weak point. This is then called a Intervertebral disc bulge or one Disc protrusion. This can occur in any part of the spine.

It differs from a herniated disc (intervertebral disc prolapse) in that the fibrous ring is completely torn and the gelatinous core can emerge when the herniated disc occurs, whereas the fibrous ring only has weak points in the protrusion where the core bulges.

frequency

in the Age Disc protrusions are becoming increasingly common. This is due on the one hand to the aging processes of the body and on the other hand to the decreasing mobility and movement.

Most people have a bulging disc between the ages of 30 and 45.

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The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.

The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
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Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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causes

A Intervertebral disc bulge can often not only be found in the area of Cervical spine attributed to aging processes in the body.

The intervertebral discs lose weight with age liquid and thus on elasticity. Due to the constant pressure that is exerted on the intervertebral discs, they become thinner over time and can no longer cushion movements as well as in normal cases.

Also Sedentary lifestyle increases the likelihood of one Intervertebral disc bulge or even one Herniated disc of the cervical spine to get sick. The little movement means that the intervertebral discs are no longer adequately supplied with nutrients and can no longer perform their function optimally. As it often leads to a lack of exercise in old age elderly as a result of this and the accompanying aging processes, more susceptible to diseases of the intervertebral disc.

But also one too high load of the Cervical spine Lifting the head too heavily or turning the head very quickly can lead to a bulging disc.
Especially in people who have weak connective tissue.

Often lead to permanent Incorrect loadshow long Sitting in front of the computer or long driving, for example with long-distance drivers, to such a clinical picture.

Also can Car accidentsthat go hand in hand with heavy braking and throwing the head forward Intervertebral disc bulges in the area of ​​the cervical spine.

Symptoms

With a bulging disc in the cervical spine, symptoms are related to the extent of the bulging, the location, and the speed at which the disease progresses.

If the protrusion of the intervertebral disc slowly develops, the disease often goes on for a long time without symptoms. Even if the bulging disc does not directly compress a nerve, it is usually not noticed for a long time.
However, if the bulging intervertebral disc presses on one of the spinal nerves that run directly in front of it, this often causes severe pain.

With a bulging disc in the area of ​​the cervical spine, this pain occurs in the area of ​​the neck and upper back. It is also possible for the pain to radiate into the arms and legs, as the spinal nerves pull up there.

In addition, numbness or tingling sensations can occur in the arms and fingers. Headaches in the back of the head are also a typical symptom.
Concomitant symptoms of a bulging disc may be dizziness and ringing in the ears.

A bulging disc can also lead to symptoms of paralysis. If the cervical spine is affected, these affect the arms and fingers.

For more information, see: Symptoms of a herniated disc

Pain with a bulging disc in the cervical spine

If an intervertebral disc has bulged outwards in the area of ​​the cervical spine, the cushioning, protective effect of the intervertebral discs is no longer guaranteed at this point on the spine. That is, parts of the bone of the upper and lower vertebral bodies rub against each other when moving. This can be light at first and then too strong later Pain in the area of ​​the Neck to lead.

Whether symptoms occur with a bulging disc depends on how quickly the disease progresses and on the location of the bulging.
If the bulge develops over several weeks and months, the patient usually does not feel any pain. However, if the protrusion develops more quickly and compresses (constricts) spinal nerves, this is noticeable through severe pain.

The pain occurs here both in the neck area and upper back on, but can also be up radiate into the arms. This is because the pinched spinal nerves pull from the area of ​​the cervical spine to the fingertips.The pain is often described as very severe and is referred to as dull, deep-seated and partly burning felt. Certain changes in the position of the head and movements of the shoulders can increase or relieve pain.

Initially, this pain is only present when moving, but later the pain can also occur at rest and be of a very strong character. In the case of a very pronounced herniated disc, it can happen that the affected person also Numbness in the arms to have. Since the neck and head area is connected with many complex nerve connections, pain in the neck area caused by a bulging disc can also occur radiate into the headwhat too uncomfortable, especially in the Pain radiating from the back of the head leads.

Tingling with a protruding disc

A tingling sensation in the arms and fingers is also typical for a bulging disc in the cervical spine.
This sensory disturbance can also be traced back to a mechanical irritation of nerve fibers and is often described by those affected as "pins and needles". Likewise is a Numbness possible in the area of ​​the arms and fingers if the sensitive nerve fibers are strongly compressed.
Another possible symptom of a bulging disc can be Signs of paralysis be. In the case of a protrusion at the level of the cervical spine, the Arms and hands affectedso it's here too Muscle weakness can come.
While pain is a relatively unspecific symptom, tingling, numbness or paralysis in the arm area are groundbreaking for a bulge or a herniated disc in the cervical area. If a muscle weakness is observed at the latest, a doctor should be consulted, because this muscle weakness in extreme cases also affect the respiratory muscles can. However, weaknesses in the muscles are less common when the intervertebral disc protrudes and rather indicate a manifest herniated disc.

For more information, see: Does tingling indicate a herniated disc?

diagnosis

To a Disc protrusion of the cervical spine to recognize and get them from one Herniated disc of the cervical spine To differentiate, imaging techniques must be used.
The differentiation is very important due to the different therapeutic approaches.
While with one Herniated disc of the cervical spine surgery must be taken into account, this should be prevented in the event of a protrusion.

In order to be able to see the intervertebral disc clearly, a Magnetic resonance imaging of the cervical spine (MRI of the cervical spine) or a computed tomography (CT of the cervical spine). Not only the bones can be seen here, but also other structures, i.e. the core and the fiber ring of the intervertebral disc
The MRI of the cervical spine in particular has proven to be particularly valuable in diagnostics.

Please also read our topics:

• MRI of the cervical spine
  and
• MRI for a herniated disc

therapy

Treating a protruding disc is similar to treating a herniated disc in the cervical spine.

First of all, the acute pain should be suppressed by administering analgesic medication. As the disease progresses, heat and ointments that relax the muscles are often found to relieve pain.

However, it is not enough just to treat the acute painful state. Long-term treatment to reduce the protrusion of the disc and prevent its recurrence should be sought.

This can be achieved through regular exercise to strengthen the back and abdominal muscles. If a certain stability is guaranteed here, the stress on the intervertebral discs can be reduced. Sports such as Nordic walking, hiking and swimming are particularly suitable for this. Gymnastics, yoga and Pilates are also very suitable for prevention. Regular visits to the gym also help to strengthen the muscles and are recommended over the long term.

To do this, physiotherapy is necessary at the beginning, whereby exercises are learned that should be done regularly at home.

Activities that stress the cervical spine should be avoided as far as possible. If you are sitting at the computer for long periods of time, you should pay attention to the posture of your head and back and correct them if necessary.

Heavy physical activity and heavy lifting should also be avoided.

Surgical therapy is usually not carried out, as in most cases targeted exercises reduce the protrusion and the patient is symptom-free. However, if the intervertebral disc presses on a nerve and causes severe pain or restrictions, surgery should be considered as a possible therapy.

Please also read our topic: Therapy of a herniated disc of the cervical spine

Exercises for a bulging disc

Disc protrusions, also known as Disc protrusions, join on the one hand Signs of wear and tear the spine on, but also through strong physical Improper loading over a longer lifetime. If the intervertebral disc bulges, there are some exercises that can help relieve symptoms and should ensure that the intervertebral disc does not bulge any further.

An essential exercise is that Elongation. In a room, you should walk on tiptoe and stretch your arms against the ceiling with the aim of reaching the ceiling with your fingers. The movement should be done in a bobbing and bouncy manner, always trying to get as far as possible. If pain develops, the extension should be reduced. It is important to keep your head facing forward and not look at the ceiling.

Another exercise that also provides stretch is to do yourself horizontally on a rubber ball to lay. Your arms should be on the floor like a push-up, with the ball touching your body at thigh level. Then it must be carefully moved forwards and backwards. This also leads to a gentle stretching of the vertebral bodies of the cervical spine.

In addition to stretching exercises, the Exercise of the Musculaturethat passes next to the spine should be respected. There are also numerous Pilates exerciseswhich aims to train the back muscles.

Exercise with a bulging disc

If there is a protruding intervertebral disc in the area of ​​the cervical spine, careful attention should be paid to the movements that can be performed. So there are sports that are very pain reliever in herniated discs are and also prophylactic ensure that the intervertebral disc does not slip out any further. Sports that one easily stretching Component can have problem-free be performed. This includes e.g. Backstroke, Nordic walking and roller blading or cross-country skiing. Sports are also good that no quick change of movement include.

But there are also sports in which there is a high risk of the intervertebral disc slipping out further. Fast turning and / or stopping movements ensure that great forces act on the intervertebral disc and that there is a risk of further worsening of the diagnosis and the symptoms. Avoided Sports that compress the spine should therefore be unnecessary tug or twist could. This includes bowling and skittles, tennis, table tennis, squash, all sports with weights, badminton, gymnastics and weight lifting.

Prognosis and course - healing process

The duration of the illness cannot be predicted in this way. This depends very much on the external circumstances of the patient.
Depending on how much exercise, how much restraint in sporting activities and how regularly the prescribed exercises are carried out, healing can be prolonged or shortened.

In most cases, a protruding disc is uneventful, but takes a relatively long time (three to six months).

If treatment is not given in time, or if the recommended restrictions are not taken into account, severe forms can occur. Chronic frozen shoulder can occur when there is increased pressure on the intervertebral discs in the cervical spine for a long time.

In addition, if the symptoms persist without treatment, a protruding disc can turn into a herniated disc. Here the fibrous ring is completely torn and the prognosis is worse compared to the bulging, i.e. with a longer course of the disease and possibly associated with an operation.

You can also read more on this topic at: Course of a herniated disc