Prolapse of the neck (cervical prolapse)

Prolapse of the neck is a condition of injury in one of the intervertebral discs in the cervical spine (neck). Prolapse of the neck (neck prolapse) means that the softer mass (nucleus pulposus) has pushed through the more fibrous outer wall (annulus fibrosus) and thus presses against the spinal canal.

It is important to know that prolapse of the neck can be asymptomatic or symptomatic. With pressure against nerve roots in the neck, neck pain and nerve pain down the arm can be experienced similar to the nerve root that is irritated / pinched.

In this article we talk more about:

• Strength and Stretching Exercises for Neck Prolapse (with video)

• Symptoms of Neck Prolapse

• Causes of Neck Prolapse

• Who Is Prolapse In The Neck?

• Diagnosis of Neck Prolapse

  + Imaging

• Treatment of Prolapse of the Neck

• Exercises for neck prolapse

Scroll below to see more training videos with good exercises for you with neck prolapse.

VIDEO: 5 Clothes Exercises against Stiff Neck and Nerve Pain in the Neck

Prolapse in the neck and tense neck muscles often (unfortunately) go hand in hand. This is because an area around a disc injury often becomes extremely pain-sensitive and thus causes considerable muscle tension. Regular use of gentle stretching exercises can help release pressure against irritated nerves and loosen up in tight neck muscles.

These five movement and stretching exercises are gentle and adapted.

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VIDEO: Strength Exercises for the Shoulders with Elastic

Many people underestimate the importance of shoulder function for a healthy and healthy neck. By strengthening the shoulders and shoulder blades, you can relieve overloaded neck muscles, stiff joints and irritated nerve roots. This training program shows you how to train with elastic to get the most out of the workout.

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Definition - Cervical prolapse

'Prolapse' indicates that it is the soft intervertebral disc mass that has pushed out through the outer wall. The diagnosis usually affects the lower back or neck - when it comes to cervical prolapse, this is (normally) more serious than lumbar (lower back) prolapse - this is because some of the nerve roots in the neck i.a. controls the diaphragm / breathing function. 'Cervical' means that it is the neck that is affected.

Symptoms of neck prolapse (cervical prolapse)

Typical symptoms are radiant or hurried arm pain / discomfort originating from the neck. Often called nerve pain. The symptoms will vary depending on whether it is a nerve root that is affected or not - as mentioned, a prolapse can be asymptomatic if there is no pressure on nearby nerve roots. If there is in fact root affection (pinching of one or more nerve roots) the symptoms will vary depending on which nerve root is affected. This can cause both sensory (numbness, tingling, radiation and impaired sensation) and motor (reduced muscle power and fine motor skills) symptoms. Prolonged squeezing can also lead to decreased muscle strength or muscle wasting (atrophy).

Does prolapse hurt?

A prolapse can cause symptoms or not - a disc injury does not mean neck and arm pain. In other words, people can walk around with prolapse and be completely pain free. This is further determined by whether there is pressure / pinching against nearby cervical nerve roots - which is determined by the prolapse's position, size, direction and appearance.

Numbness and Radiant Pain

Such symptoms can be numbness, radiation, tingling and electric shock that shoots down into the arm - it can also occasionally experience muscle weakness or muscle wasting (with prolonged lack of nerve supply). Symptoms may vary.

In folklore, the condition is often incorrectly called 'disc slipping in the neck'. - this is wrong as the discs are stuck in between the cervical vertebra and can not 'slide out' - only the soft mass inside the disc can move like this (ie not the disc itself, but only the contents). Feel free to contact us at Our Facebook page if you have any questions or comments.

Root infection against C7 (may occur by prolapse in C6 / C7)

• Sensory sensation: Impaired or increased sensation may occur in the associated dermatoma that extends all the way into the middle finger.
• Motor skills: The muscles that have their nerve supply from C7 can also be experienced weaker during muscle testing. The list of muscles that can be affected is long, but often the impact is most visible when testing the strength of the triceps or lattissimus dorsi, as these only get their nerve signals from the C7 nerve root. Other muscles that are affected, but which are also supplied by other nerves, are the forearm muscles (including pronator teres and flexor carpi ulnaris), as well as wrist flexors and wrist pullers.

FYI: It is thus the lower nerve root that is affected by prolapse in levels in the neck - if there is a prolapse in C7 / T1, it is the nerve root C8 that is affected. But if there should be a prolapse in T1 / T2, ie between the two upper thoracic vertebrae, then it is the nerve root T1 that can be affected.

Why do most neck prolapse occur in the lower cervical vertebrae?

The reason why these two areas are most often affected is due to pure anatomy. These are areas that are located at the bottom of the neck and thus must do most of the work when it comes to shock absorption and carrying the head. They are also particularly vulnerable when working in forward-bent and static working positions (eg which is also one of the positions where most neck kicks and ailments occur). What many do not know is that these acute kinks and 'cuts' in the neck occur as a defense mechanism to prevent you from damaging more delicate structures such as the soft intervertebral discs. It's simply the body's way of telling you that you've tried to do something that you do not have enough supporting muscles or function to perform - and it asks you to heed its warnings. Many people choose not to listen when the body reports danger and thus stress injuries occur - such as. disc injuries or disc disorders in the neck.

Also read: - 5 Custom Exercises For You With Neck Prolapse

Why do you get neck prolapse? Possible causes?

There are many factors that determine whether you get prolapse, both epigenetic and genetic.

Genetic causes

Among the congenital reasons why you can get prolapse, we find the back and neck shape and curves - for example, a very straight neck column (so-called straightened cervical lordosis) could lead to load forces not being distributed across the joints as a whole, but then rather, it strikes what we call transition joints since the forces thus travel straight down through the column without being reduced through the curves. A transition joint is the area where one structure passes into another - an example is the cervicotoracal transition (CTO) where the neck meets the thoracic spine It is also no coincidence that it is in this particular joint between C7 (lower neck joint) and T1 (upper thoracic joint) gets the highest incidence of prolapse in the neck.

Anatomically, one can also be born with a weaker and thinner outer wall (annulus fibrosus) in the intervertebral disc - this will, naturally enough, have a higher risk of being affected by disc injury / disc prolapse.

epigenetics

By epigenetic factors is meant conditions around us that affect our lives and our state of health. These can be socio-economic conditions such as poverty - which means that you may not be able to afford to see a clinician when the nerve pain first started, and which thus led to you not being able to do the things that were necessary to do before a prolapse occurred. . It can also be diet, smoking, activity level and so on. Did you know, for example, that smoking can lead to increased muscle pain and poorer healing due to reduced blood circulation?

Job / load

A workplace that contains many heavy lifts in unfavorable positions (eg forward bending with twisting) or constant compression (pressure through the back - eg due to heavy packing or bulletproof vest) can over time lead to overload and damage in the lower soft the intervertebral discs. This in turn can cause the soft mass to leak out and provide a basis for a prolapse. In case of prolapse in the neck, it is often seen that the person has a static and demanding job - among other things, several veterinarians, surgeons and dental assistants are affected due to their occasional static positions when they work.

Who is affected by cervical prolapse?

The condition primarily affects younger people aged 20-40 years. This is due to the fact that the inner mass (nucleus pulposus) is still soft at this age, but that it gradually hardens with age and that thus the chance of prolapse is also reduced. On the other hand, there are often wear changes and spinal stenosis more common causes of bone pain in those over 60 years.

- The neck is a complicated structure that needs some training and attention as well.

Does a prolapse disappear by itself? Or do I need help?

A prolapse is a dynamic structure. That is, the body recognizes it as a problem and consistently tries to break it down by sending enzymes to the site. These enzymes try to 'eat up' the part of the disc core that has pushed through the outer wall. So in an ideal world, prolapse will gradually recede and disappear. The only problem is that a person who has had a prolapse has unfortunately often had this due to unfavorable habits, poor lifting technique / training technique and generally too little training of the core / back muscles. The person must thus completely change behavior, exercise habits and movement patterns - and that is easier said than done. Then it may be okay with a little external help from e.g. physiotherapist or modern chiropractor (someone who works with muscles, joints and exercise) - these can tell you what you are doing wrong and what your focus should be on in the future to maximize the chance of healing.

Diagnosis of prolapse of the neck

A clinical examination and history taking will be central in diagnosing 'cervical prolapse'. A thorough examination of muscular, neurological and joint function is important. It must also be possible to exclude other differential diagnoses. See a doctor, chiropractor or manual therapist to diagnose your pain - these three publicly authorized health professions have the longest educations and also have the right to be referred to diagnostic imaging (e.g. MRI examination should this be needed).

Neurological symptoms of cervical prolapse

A thorough neurological examination will examine strength of the lower extremities, lateral reflexes (patella, quadriceps and Achilles), sensory and other abnormalities.

Image diagnostic investigation of cervical prolapse (X-ray, MRI, CT or ultrasound)

X-rays can show the condition of the vertebrae and other relevant anatomical structures - unfortunately it can not visualize current soft tissue and the like. One MRI examination is the most frequently used to diagnose cervical prolapse. It can show exactly what is the cause of nerve compression. In those patients who cannot take MRI due to contraindications, CT can be used with contrast to evaluate the conditions.

X-ray of cervical prolapse

MRI image of prolapse in the neck

This MRI examination shows spinal pinching in between cervical vertebrae C6 and C7 due to a disc herniation.

CT image of cervical prolapse

Here we see a CT image without contrast that shows the neck and head. CT is used when a person cannot take an MRI image, e.g. due to metal in the body or implanted pacemaker.

Treatment of cervical prolapse

One does not normally treat the prolapse itself, but rather the symptoms and dysfunctions around the injury itself. This may involve physical treatment of nearby tight muscles and joint treatment of stiff joints to ensure the best possible function. Traction therapy (also called spinal decompression) can also be a useful tool to remove the compression pressure away from the lower vertebrae, discs and nerve roots. Other treatment methods are dry needling, anti-inflammatory laser treatment and / or muscular pressure wave treatment. Treatment is of course combined with gradual, progressive training. Here is a list of treatments used for cervical prolapse. The treatment can be performed by, among others, public health-authorized therapists, such as physiotherapists, chiropractors and manual therapists. As mentioned, it is also recommended that treatment be combined with training / exercises.

Physical treatment

Massage, muscle work, joint mobilization and similar physical techniques can provide symptom relief and increased blood circulation in the affected areas.

Physiotherapy

 It is generally recommended that patients with cevical prolapse be instructed to exercise properly through a physiotherapist or other clinician (eg, a modern chiropractor or manual therapist). A physiotherapist can also help with symptom relief.

Surgery / surgery

If the condition worsens significantly or you do not experience improvement with conservative treatment, surgery may be necessary to relieve the area. An operation is always risky and is the last resort.

Laser Therapy

Laser therapy with class 3B laser apparatus has also shown documented effects on neck prolapse. The treatment can stimulate repair and cause the condition to heal itself faster than without treatment. According to the Radiation Protection Regulations, laser therapy should only be used by authorized health professionals, and the regulation states that only a doctor, chiropractor and physiotherapist are approved for such use.

Traction bench / cox therapy

Traction and traction bench (also called stretch bench or cox bench) are spinal decompression tools that are used with relatively good effect. The patient lies on the bench so that the area to be pulled out / decompressed ends up in the part of the bench that divides and thus opens up the spinal cord and relevant vertebrae - which we know provides symptom relief. The treatment is most often performed by a chiropractor, manual therapist or physiotherapist.

Also read: 11 Exercises against Ishialgi

Surgery of prolapse of the neck

Public orthopedic surgeons set strict requirements in relation to whether prolapse surgery should be performed - unfortunately private clinics do not always do this. The reason they are so severe is that neck surgery involves a high risk if something goes wrong - such as worsening of the pain or permanent injuries. Therefore, neck surgery is reserved only for those who really need it and who e.g. has CSM.

Several studies have shown that surgeries often have a good short-term effect, but that in the long run it can lead to worsening symptoms and pain. This may be due to the formation of scar tissue / injury tissue in the operated area, which in the same way as the removed prolapse exerts a pressure on nearby nerve roots. The only difference is that scar tissue and damage tissue cannot be removed. One must also take into account that it is operated on in a very sensitive area, and that there is therefore a chance that the surgeons damage the nerves - which in turn can lead to worsening nerve symptoms / ailments and / or permanently reduced muscle strength and atrophy.

Choose exercise over the scalpel

It can be incredibly tiring, painful and frustrating with a prolapse in the neck, but we strongly recommend that you try all options before going under the knife. Yes, the scalpel is perhaps the most 'attractive choice' with its false promises of a quick fix solution, but a gradual training is always the best (but most boring) choice. Work hard and purposefully. Set yourself intermediate goals and get help from a clinician - this way you can stay motivated and avoid doing exercises that you absolutely should not do.

Exercises against cervical prolapse

Exercises aimed at relieving symptom relief in the neck will primarily focus on relieving the affected nerve, strengthening relevant muscles and especially rotator cuff, shoulder and neck muscles. Among other things, we recommend that you focus on to train your shoulder muscles. We also recommend that you get a specific exercise program from a clinician that is right for you. Later in the progression, sling training is also relevant.

Related article: - How To Get Stronger In The Shoulders And Shoulder Blades

Further reading: - Pain in the neck? THIS YOU SHOULD KNOW!

Sources:
- PubMed

Frequently asked questions regarding neck prolapse / neck prolapse / disc injury:

Can one get a sore throat by prolapse of the neck?

Yes, one can get a sore throat due to tense muscles in the neck that refer to pain towards the back, front or side of the neck. This often involves myalgia of the sternocleidomastoid - which is a muscle that is often overactive in prolapse of the neck due to its desire to protect the injured area. Other muscles that can cause pain in the neck are the upper trapezius, scalenii and jaw muscles (digastric and pterygoids).

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