What cervical disc disease is
Between the cervical vertebrae lie intervertebral discs, which lose water and height with age. Changes like these show up on MRI in a large proportion of adults, including people who have no pain at all – so a report saying “C5-C6 disc disease” is not yet a diagnosis. The problem begins when a disc herniation or bony outgrowths narrow the opening through which the nerve root exits. We then speak of cervical radiculopathy (a radicular syndrome): pain, tingling or weakness travel from the neck into the arm, usually along a specific strip of skin and into particular fingers.
A stiff neck and a headache after a day at the computer are a different picture – we describe that on the page about neck pain. A rarer but more serious situation is compression of the spinal cord itself, known as myelopathy. It causes clumsiness in both hands and an unsteady gait, often without severe pain, and needs urgent medical investigation.
How we tell the disc apart from other causes of arm pain
Arm pain does not always come from the neck. Shoulder problems, a nerve compressed at the wrist or the elbow, and trigger points in the muscles of the neck and shoulder girdle can all show up in a similar way. That is why we start the assessment with a map of the symptoms: where exactly it hurts, which fingers go numb, what brings relief and what makes it worse.
Then we check sensation, the strength of individual muscle groups and the reflexes, and carry out neck provocation tests and nerve tension tests. We also assess walking and hand dexterity so as not to miss signs of myelopathy. If anything in the examination points to it, we do not start treatment – we refer you to a doctor instead.
Conservative treatment and a realistic pace of improvement
Nerve root pain from the neck can be very unpleasant, but in most people it eases clearly within a few weeks, and a full return takes anywhere from a few weeks to a few months. In the first phase the aim is not to irritate the nerve root: we find positions that ease the pain and use gentle manual therapy of the neck and thoracic spine, together with soft tissue work. Often this alone brings relief at night and at work. We also look at how your monitor is set up and how you use your phone – not because a bent head “wrecks” the discs, but because many hours in one position can keep the nerve root irritated.
Next we introduce exercises – for the deep neck flexors, the shoulder blade muscles and nerve glide – and gradually make them harder. These are what make the effect last. Manual therapy helps you get through the most painful period, but it will not replace exercise. At every visit we check the strength of the arm: if, instead of improving, it is getting weaker, we refer you to a doctor.
When to come in
It is worth coming in when the pain has been radiating into the arm for more than a few days, when it comes back with computer work or after training, and also when you already have an MRI result and do not know what it means. At the first visit we examine you, explain what the report actually means, and usually start treatment straight away. If the examination points to spinal cord compression or rapidly increasing weakness, we will refer you to a doctor first. The easiest way to arrange an appointment is via the Contact page.