How Cervical Degenerative Disc Disease Causes Pain and Other Symptoms

When a cervical disc starts losing hydration and stiffening, there are several ways in which neck pain and associated symptoms can develop. Here are the common ones.

Pain from a Degenerating Disc

Most people who have a disc tear do not experience pain from it. The exact reason is unknown, but most experts suspect it has something to do with how the disc’s innervation and pain sensory can vary from person to person. For example, some people might have nerves that naturally go deeper into the disc, while some people might simply have a higher threshold for sensing pain.

When a degenerating disc causes neck pain, it is likely from one or both of the following:

  • Discogenic pain. This pain occurs in the disc itself and can range from mild to severe. The disc’s gel-like interior, called the nucleus pulposus, contains proteins that can cause painful inflammation if they come in contact with nerves located in the outer layer of the disc.

    In a healthy adult cervical disc, nerves only go into the outer third of the disc’s protective outer layer, called the annulus fibrosus. However, if the disc’s outer layer gets a tear, then nerves can start to grow deeper into the disc in an attempt to heal itself. The soft inner portion of the disc can leak into the outer rings and come into contact with the small nerves, which can become painful. Some studies have even shown nerves growing all the way into the center of the nucleus pulposus in a painful disc that had gone through significant degeneration.

  • Micro-motion instability. When the disc’s tough outer layer wears down and no longer provides adequate shock absorption and stability, the vertebrae above and below the disc may move more than usual and surrounding muscles can go into painful spasms in an attempt to limit that abnormal movement.

See How a Disc Becomes Painful

Pain from a degenerating disc can range anywhere from a dull ache to something so intense that it limits movement and activities. In most cases, the pain will subside within a few weeks or months as chemical inflammation of the disc material starts to subside, and/or the disc stabilizes into it new stable position.

See Pain from Degenerative Disc Disease

Other Conditions Associated with a Degenerating Disc

Cervical degenerative disc disease is often present with other spinal conditions, either developing at the same time or in some cases one causes the other. Some common examples include:

    • Herniated Cervical Disc. A degenerating disc can have its nucleus wedge into tears in the annulus fibrosus. If the nucleus pulposus eventually passes through the annulus fibrosus, then the disc is considered herniated.
    • Conversely, a traumatic injury, such as a fall, or other issues could cause a herniated disc that eventually speeds up the disc’s degeneration and leads to cervical degenerative disc disease.

See Cervical Herniated Disc Symptoms and Treatment Options

    • Cervical osteoarthritis. As the disc degenerates and the disc space within the vertebral column starts to collapse, the facet joints may abnormally move or sublux and cause wear of the cartilage, as well as develop bone spurs in the neck.

See Cervical Osteoarthritis (Neck Arthritis)

    • Cervical spinal stenosis. This condition occurs when there is a narrowing of the spinal canal (where the spinal cord runs through) or foramina (where the spinal nerve runs through), due to bone spurs, as described in the arthritis scenario above.
      As an example, disc degeneration could eventually lead to osteoarthritis, which could eventually lead to spinal stenosis. For some patients, they are born with a congenital form of cervical stenosis and do not need to have disc degeneration to develop symptoms.

Watch Cervical Spinal Stenosis Video

Cervical radiculopathy—symptoms of pain, tingling, numbness, and/or weakness radiating down the shoulder into the arm and hand—can result when one or more of the neck’s spinal roots becomes pinched or irritated. For example, a herniated disc or bone spur could pinch a nerve root in the C6-C7 segment that might cause weakness in the triceps and forearms, wrist drop, and altered sensation in the middle fingers or fingertips.

See What Is Cervical Radiculopathy?

If the spinal cord at the neck level becomes compressed by spinal stenosis, such as from bone spurs or a disc bulge, then myelopathy can develop. Possible symptoms of pain, tingling, numbness, and/or weakness could be felt at that level in the neck and anywhere below. For example, a person could have tingling or weakness in the legs, balance problems, or even difficulty with bowel and bladder control.

Watch Myelopathy Video

It is important to get a medical evaluation if there are symptoms of myelopathy, as the condition may progress and without treatment it is possible to eventually develop paralysis of multiple limbs and body functions.

If pain and symptoms from cervical degenerative disc disease intensify, steps can be taken to help alleviate the problem. The first steps are usually self-care and/or non-surgical treatment options, and typically these will effectively manage the pain.

See Neck Pain Treatment

Cervical Degenerative Disc DiseaseCervical degenerative disc disease is diagnosed when a damaged disc in the spine becomes symptomatic. Watch: Cervical Degenerative Disc Disease Video

In rare cases when pain and symptoms persist or worsen despite several months of treatment, or if spinal cord health is at stake, surgery may be considered.

See Surgery for Neck Pain Symptoms

Non-Surgical Treatment Options

For neck pain stemming from cervical degenerative disc disease, a doctor will typically recommend one or a combination of the following treatment options:

    • Rest or lifestyle modification. Certain activities might be more painful for the neck, such as craning the neck forward to look at the computer monitor or a specific swimming stroke. Refraining from or modifying certain activities for a few days or weeks will usually reduce the pain. In addition, maintaining strong posture(instead of slouching while sitting or flexing the neck forward while driving, looking at a cell phone, etc) is recommended. Eating healthy, staying hydrated, and quitting smoking are also all beneficial for disc health.

See Lifestyle and Diet Tips for Healthy Bones

    • Pain management with medication or injections. Over-the-counter pain relievers, such as acetaminophen (such as Tylenol), ibuprofen (such as Advil, Motrin), or others might be beneficial. If not, a stronger pain medication, such as oral steroids or muscle relaxants (such as Vicodin) may be prescribed. Other options could include an injection that delivers medication directly to a certain part of the neck, such as a cervical epidural steroid injection or a cervical facet injection.

See Pain Medications for Degenerative Disc Disease Treatment

    • Ice and/or heat therapy. Some people find pain relief by applying an ice pack or a heated gel pack to the uncomfortable part of the neck.

See Heat Therapy Cold Therapy

    • Exercise and/or physical therapy. Most non-surgical treatment programs for neck pain will include some form of exercise and stretching. A physical therapist or other trained health professional can prescribe an exercise and stretching regimen that meets the specific needs of the patient. In general, increasing strength and flexibility in the neck can lower the risk for pain.

See Neck Exercises for Neck Pain

    • Manual manipulation. The cervical spine can be manually adjusted by a chiropractor or other qualified health professional in an effort to improve range of motion and/or reduce pain. Depending on the person’s symptoms, a physical exam and/or imaging study should be done prior to manual manipulation of the neck.

See Chiropractic Manipulation for the Cervical Spine

The above list does not include all treatment options for pain related to cervical degenerative disc disease. Many other options could be considered as well, such as massage therapy, electrical stimulation (TENS unit), bracing, or acupuncture.

See Acupuncture: An Ancient Treatment for a Current Problem

Surgery for Cervical Degenerative Disc Disease

Surgery to treat cervical degenerative disc disease is generally considered in two cases:

  • Neurological symptoms are present, such as persistent arm numbness and/or weakness, or trouble with walking or bowel control. If neurological symptoms are caused by cervical DDD there is a risk of permanent nerve damage, and surgery may be recommended to alleviate pressure on the nerve.
  • Chronic pain is severe and not adequately relieved after at least six months of non-surgical treatments, and daily activities become difficult. Better surgical results are predicted for patients with chronic pain coupled with other findings such as cervical instability, and/or radiculopathy.

See Deciding on Surgery for Degenerative Disc Disease

The two most common types of surgery for cervical degenerative disc disease are:

    • Anterior cervical discectomy and fusion (ACDF). This procedure is done through the front of the neck and involves removing the problematic disc, decompression of the nerve root, and insertion of a bone graft or a metal cage device to help maintain or reestablish the normal height of the disc space.

      See ACDF: Anterior Cervical Discectomy and Fusion

      If there are neurological symptoms from spinal cord compression, the surgery may also include removing part of a vertebra or widening the spinal canal to give more space for the spinal cord before the fusion is done.

See ACDF Surgery Procedure

    • Cervical artificial disc replacement. This surgery involves removing the problematic disc and replacing it with an artificial disc. The goal of this surgery is to preserve motion at that spinal level. Artificial disc replacement results may be better in patients with minimal arthritic changes to the posterior facets.

See Artificial Disc for Cervical Disc Replacement

For relieving pressure on nerve roots and/or the spinal cord and thus reducing neurological symptoms like arm pain or weakness, neck surgery tends to have a good success rate—some estimates in literature are between 80% and 90%.4

See What Causes Hand Pain and Numbness?

However, neck surgery has a lower success rate for relieving pain that is only in the neck itself.4 If the disc space cannot be verified as the probable pain generator, it may be reasonable to avoid surgery and keep trying various types of non-surgical care to manage the pain.

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