Cervical Disc Herniation
What is a Cervical Disc Herniation?
A cervical disc herniation occurs when the inner material of a spinal disc bulges or leaks out, pressing on nearby nerves. This can cause localized neck pain as well as pain radiating into the shoulder, arm, or hand.
Common Symptoms
Neck pain and stiffness
Radiating pain into the arm or hand
Tingling, numbness, or weakness in the arm
Pain worsened by coughing, sneezing, or certain neck positions
How a Physical Therapist Diagnoses a Cervical Disc Herniation
Physical therapists use neurological exams (strength, sensation, reflexes) along with special tests such as Spurling’s test or cervical compression/distraction tests. A thorough history and symptom pattern help distinguish disc herniation from muscle strain or joint restriction.
Why it Happens
Disc herniations may develop gradually due to age-related changes or suddenly from a lifting or twisting movement. Poor posture, repetitive stress, and reduced spinal stability also contribute.
Why it Doesn’t Always Heal on Its Own
Some herniations improve as inflammation subsides, but many persist without treatment. Ongoing compression of a nerve can lead to prolonged pain or weakness, requiring targeted rehabilitation to restore mobility and stability.
Ideal Physical Therapy Treatment
The best treatment combines pain-relieving strategies with progressive strengthening and mobility work. While dry needling is not directed at the disc itself, it may help reduce muscle spasm around the neck that contributes to pain and limits mobility.
Key components include:
Gentle traction or manual therapy to relieve nerve pressure
Dry needling for secondary muscle tension and protective guarding
Postural training to reduce spinal stress
Stability exercises for deep neck and upper back muscles
Neurodynamic and mobility exercises to improve nerve and joint health
Progressive strengthening for return to sport and daily activities
Expected Outcomes
Most individuals improve significantly with conservative care, regaining mobility and reducing pain. A small percentage may require surgical consultation if symptoms do not resolve, but physical therapy is highly effective in many cases.