As is the case with back pain, neck-related discomfort is often temporary. For those times when it’s not, it may be due to symptomatic cervical disc disease (SCDD), a general term used to describe local or radiating neck pain felt in the shoulders and arms caused by worn or damaged discs. While more common in older adults, the condition can also be facilitated by trauma and other issues. Here’s what you need to know about SCDD.
What Causes Symptomatic Cervical Disc Disease?
The most common cause of SCDD is the progressive wear and tear of cervical discs. This usually occurs over several years and results in a gradual loss of disc height, which can eventually cause the affected discs to shift and irritate nerves or slip out of place entirely.
It’s possible to have discs in the neck that gradually wear and produce no symptoms at all until a sudden injury occurs, such as a hard fall, a sports-related impact, or a car accident. Such injuries may cause one or more discs that are already susceptible to injury to shift and trigger symptoms.
A loss of water content in spinal discs that occurs with age can also contribute to disc damage that eventually produces noticeable symptoms. Children typically have discs that are about 85 percent water. This amount drops to around 70 percent in older adults. A loss of hydration also means discs provide less cushioning and they aren’t able to repair themselves as easily. Risk factors that may contribute to SCDD include:
- Genetic conditions
- Posture and the extent of regular neck movements
- Lifestyle factors like weight and overall health
- Habits such as smoking
What Are the Symptoms of SCDD?
Depending on the extent of disc wear, symptoms associated with SCDD can be mild, severe, or somewhere in between. If a disc shifts out of place due to a sudden impact, symptoms that include sharp neck pain and numbness and/or weakness in shoulders and arms may come on suddenly. Patients with SCDD may also experience:
- Pain that becomes more noticeable with movement
- Reduced range of motion in the neck
- Sharp, “electric shock-like” pain that may extend to hands and fingers (usually on one side of the body)
- Difficulty with coordination and balance
- Loss of bladder/bowel functions (rarely occurs)
If the main symptoms associated with SCDD are solely related to worn discs, pain may go away over time as the discs shift. It’s usually when the degeneration extends to other structures in the neck like facet joints that symptoms become more chronic (lasting 4-6 months or more) in nature.
How Is SCDD Diagnosed and Treated?
If SCDD is suspected following a physical examination and a review of medical history and symptoms experienced, your doctor may refer you to a Santa Monica spine surgeon for further evaluation. A diagnosis is usually made based on tests that include range of motion testing and imaging studies (e.g. X-rays, CT scans, and MRIs).
After an accurate diagnosis is made and contributing factors have been identified, such as bone spurs or damage to facet joints, a treatment plan can be recommended. Initial attempts at relief and pain management typically involve a combination of the following conservative treatment options:
- Anti-inflammatory medications
- Activity modification
- Over-the-counter pain relievers
- Heat/ice therapy
- Short-term rest followed by strength-training exercises and/or gentle neck stretches
- Massage therapy
- Manual manipulations performed by a chiropractor
- Corticosteroid injections
When Is Surgery Considered?
Barring a medical emergency, surgery for SCDD usually becomes a consideration if conservative treatments aren’t producing noticeable results after six weeks or so. The specific procedure recommended will depend on the extent of symptoms and the identified source of the issue.
Some patients may benefit from a decompression procedure to relieve pressure on nerve roots, while others may need fusion surgery or a similar stabilization procedure. Most common neck procedures can be done with minimally invasive techniques. Two common options are:
- Anterior cervical discectomy and fusion (ACDF) – Done from the front of the neck, this procedure involves removal of the problem disc and the use of graft material or a metal cage to restore disc height.
- Cervical artificial disc replacement – An artificial disc replaces the damaged one. The main benefit of this option is that full neck motion is maintained.
SCDD isn’t entirely preventable. However, making an effort to maintain good overall health can be helpful. You may also be able to minimize age-related disc wear by watching your upper back and neck posture as you work, stand, sleep, and play sports. Also, be mindful of how you bend your neck when using various devices. Finally, report any neck, shoulder, or arm pain that isn’t going away to your doctor and speak with a spine specialist to determine if you need to undergo a procedure such as ACDF. Santa Monica patients can call 310-828-7757 to schedule an appointment at The Spine Institute.