HEALTH MATTERS: Say goodbye to that pain in your neck – centraljersey.com

If you ever ate a jelly doughnut, you know how the jelly filling can ooze out and make a mess on your hands and fingers.

Well, your cervical discs are much like jelly doughnuts, and when the gel-like substance inside the disc leaks out or dries up, it can cause chronic pain and reduced mobility.

Cervical disc disorders are common, especially as you grow older, but they are often treatable with physical therapy or steroid injections.

However, for patients with severe disc problems, University Medical Center of Princeton offers advanced options for cervical disc surgery, including artificial disc replacement.

Your cervical spine is composed of seven small vertebrae that along with various muscles and ligaments form your neck. These vertebrae protect your spinal cord and the nerves that branch out from the cord, and provide support for your head.

Between each vertebra are cervical discs, which are made of a tough flexible outer ring and a soft, jelly-like center. These discs cushion your vertebrae and serve as shock absorbers when you walk or run.

But wear and tear as you age, and damage from accidents or injuries sustained from physical activities, can cause discs to break down or bulge and rupture (herniate), resulting in pain.

More than 16 million Americans visited a doctor or hospital for neck pain treatment in 2014, according to the United States Bone and Joint Initiative. And while cervical disc disorders accounted for only 15 percent of those visits, the condition was responsible for 33 percent of neck-pain related hospitalizations.

Two of the most common causes of neck pain are a pinched nerve due to a herniated disc and spinal stenosis due to degenerative changes.

When a disc herniates, the gel-like substance can leak out and put pressure on the nearby nerve, causing pain and weakness in the area the nerve supplies.

In most cases, the pain starts in the neck and travels down the arm in the area served by the damaged nerve. Symptoms include:

Pain that increases with certain neck movements like extending or straining the neck or turning the head

Weakness in the muscles of the arm, shoulder or hand

Numbness or tingling in the shoulder, arm or hand

Spinal stenosis is a narrowing and stiffing of the spine, caused by degenerative changes that happen with age.

As you grow older, the discs in your spine lose height and begin to bulge. They also lose water content, begin to dry out and become stiffer. Over time, they settle or collapse, and the bony vertebrae move closer together.

In response, your body forms more bone bone spurs around the disc to strengthen it. However, these spurs cause the spine to stiffen and the spinal canal to narrow, putting pressure on nerves.

For many people, spinal stenosis causes no symptoms, but when symptoms do occur they may include:

Neck pain, though not always severe

Numbness or weakness in the shoulder, arms and legs

Balance and gait problems

Trouble with fine motor skills, such as buttoning a shirt or zipping a coat

Bladder or bowel problems, in severe cases

Advanced treatment options

Most cervical disc disorders can be diagnosed with a physical exam, X-rays and MRI.

While X-rays can show any narrowing of the spinal canal, an MRI is necessary to show bulging or herniated discs and detect damage to the spinal cord or nerve roots.

Once diagnosed, the first line of treatment for cervical disc disorders typically involves physical therapy and nonsteroidal anti-inflammatory drugs like aspirin or ibuprofen. In some cases, steroid injections may be recommended to help relieve pain and swelling around the nerve.

If disc problems are severe enough, doctors may recommend surgery. The traditional approach has been cervical disc fusion, which involves placing a piece of bone between the affected vertebrae to create more space and relieve pressure on the nerves.

The downside of cervical disc fusion, however, is that it can affect range of motion.

Now, advances in spinal surgery at UMCP mean some patients may be candidates for artificial disc replacement, which can retain some flexibility and movement while relieving pain.

Like meniscus replacement surgery in the knee, artificial disc replacement involves removing the degenerated disc in the neck and replacing it with an artificial, titanium disc.

The minimally invasive surgery is performed through a 1- to 2-inch incision typically along the neck crease, and can be done in an outpatient setting.

Artificial disc replacement is particularly beneficial for patients who still have good range of motion in their neck.

If you are suffering from neck pain, see your doctor for an appropriate diagnosis and treatment approach that is right for you.

For more information about UMCPs spinal services or to find a physician with Princeton HealthCare System, go to www. princetonhcs.org or call 888-742-7496.

David Lamb, M.D. is board certified in orthopaedic surgery and specializes in spine surgery. He is Chief of Orthpaedic Surgery at University Medical Center of Princeton.

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HEALTH MATTERS: Say goodbye to that pain in your neck - centraljersey.com