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A cervical disc herniation can be a cause of pain
that radiates down the arm, sometimes accompanied by numbness and
tingling down into the fingertips, and sometimes muscle weakness
as well. It usually develops in men and women between 30 and 50 years
old. This is one of the most common cervical spine conditions treated
by spine specialists. The herniated disc may occur from an injury
or trauma to the spine, but it most commonly is a spontaneous development.
The arm pain occurs as a result of a disc in the cervical spine
(the neck) pinching or pressing on a nerve, which causes pain to
radiate down that nerve. Most cervical disc herniations extrude out
to the side of the spinal canal and pinch the exiting nerve root
at the next lower level of the spine.
Symptoms
Depending on which part of the cervical spine is affected, any of the following
may be symptoms of a cervical disc herniation:
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Weakness in the deltoid muscle in the upper arm
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Weakness in the biceps (muscles in the front of the upper arms)
and wrist extensor muscles
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Weakness in the triceps (muscles in the back of the upper arm
and extending to the forearm) and the finger extensor muscles
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Weakness with handgrip
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Numbness and tingling along with pain can radiate to the thumb
side of the hand, down the triceps into the middle finger, or down
the arm to the little finger side of the hand
-
Shoulder pain
This list covers some of the typical symptoms, but others may also
occur. It is possible to have a cervical disc herniation with symptoms
completely different from these.
Discs in the cervical spine are usually not very large. However,
even a small disc herniation can pinch the nerve and cause pain.
The pain is usually greatest when the nerve is first pinched.
Diagnosis
Since the symptoms vary widely, often, the best way to correctly
diagnose a cervical disc herniation is with a diagnostic imaging
test such as the following:
- MRI Scan
The best test to use is an MRI (Magnetic Resonance Imaging) scan.
An MRI scan can usually see any nerve root pinching caused by a herniated
cervical disc.
- CT Scan with Myelogram
A CT (computed tomography) scan
with myelogram may also be ordered, because it is more sensitive
than the MRI and can see subtle pinching that might be hard to
see on an MRI. This test is not usually the first one ordered because
an injection is required to place an imaging dye into the patient.
Therefore, it is best to try an MRI first in order to see if that
will be enough. CT scans without myelogram will not do much good
for diagnosing this condition so are not used.
- EMG
Occasionally, an EMG (Electromyography) may also be used. This is
an electrical test that stimulates specific nerves to see if certain
muscles may have been affected from a pinched nerve, which could
indicate cervical disc herniation.
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