Slipped disc in neck

Keywords; slipped disc in neck, arm pain, shoulder abduction relief.

This is one of the most painful and difficult conditions seen at the Chiropractic Coalface.

The nerve roots in the cervical spine find themselves precariously placed between three types of joints:

  1. The intervertebral disc joint
  2. The facet joints
  3. The joints of Luschka
  • CHIROPRACTIC HELP Whiplash and the Joints of Luschka ...

    Any one of the three, or several in combination can affect the nerve root. See how the nerve root (illustrated by the red arrow) lies between the IVD, the facet joint and the joint of Luschka?

    • Chiropractic Conditions is a central page at Chiropractic Help. It provides you simply and easily with the sorts of conditions that the average chiropractor would be treating.
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    Slipped disc in neck casefile

    Mr G, a fifty year old body builder consulted me with bad neck pain and headache radiating vaguely, but severely in the right shoulder and lower arm. The arm felt weak and there was frequent pain and tingling in the arms and hands. Bench press in particular was difficult.

    The pain had begun some five weeks previously, with no known cause. He recalled no injuries to the neck.

    He had consulted a physical therapist and another chiropractor, neither of whom could find the cause of the pain or the weakness in his arm. Nevertheless there had been some improvement in the slipped disc symptoms in his neck with their treatment, but not his arm.

    Mr G was an extremely well built man, with enormous muscles associated with body building. He wasn't carrying an ounce of fat.

    Right rotation of his head and neck, right lateral flexion, and extension, all produced pain in his neck and upper right arm.

    On observation, it was obvious that there was severe wasting of the right pectoralis major muscle and the right triceps. Both were very weak for such a strong man. I could overpower both, difficult even in a normal person.

    Kemp's test and the Upper Limb Tension Test were extremely positive, with pain in the lower cervical spine (C7 in particular) radiating radiating tingling in the arm and hand.


    Slipped disc symptoms

    The triceps reflex was absent and there were sensory changes in the middle finger; on pinwheel testing there was numbness.

    In short, there were so called hard neurological findings, affecting both the sensory and motor nerves. Slipped disc symptoms in the neck can be very severe, and unresponsive to medication.

    Depending on the severity of the bulge you may have a variety of symptoms; if it affects just the sensory nerve causing pain, tingling and numbness in the arm.

    If the motor fibre is pinched then there will be loss of reflex and weakness and wasting of muscles.

    You may experience several of these symptoms.

    • Severe neck pain
    • Severe trapezius muscle pain
    • A deep ache in the upper midback
    • Pain and tingling in the arms and hands, usually in one arm only
    • Initially, increased sensitivity in the arm known as hyperaesthesia. Later numbness develops, usually in a single dermatome; that's an area of skin supplied by just one nerve root.

  • Weakness in one or more muscles in the arm. The triceps is most commonly affected, next the small muscles in the hand. The Pec muscles in the chest may also be affected
  • Wasting of the muscles affected then occurs.

  • Extending the elbow, straightening it against resistance, is commonly weak.

    There is increased pain in the arm when stretching out the limb. Carrying a briefcase or a heavy package of groceries places increased stress on the injured nerve root.

    Conversely, placing your hand on your head, or sleeping with it under your pillow takes the tension off the nerve.

    The result is relief when raising your arm. Periodically a patient walks into the clinic with his or her hand on their head; the diagnosis is often already made. It's known as the Shoulder Abduction Relief sign.

    The deep ache in the arm is often worst at night.

    A slipped disc in neck is certainly one of the most difficult conditions to manage in any practice. It frequently leads to surgery, which in itself is complex and not without danger. Approximately one in a thousand patients die during or soon after the operation.

    Others either receive no relief or have increased pain. The same of course could be said about chiropractic patients. All professions find this a challenging condition to treat.

    A letter received at Chiropractic Help

    My right neck, arm, leg and foot are experiencing tingling and burning sensations. Sometimes my foot will feel like it has fallen asleep as well. Also, occasionally, the right side of my face feels numb. I have previously had L2-L4 interbody fusions, Disk repair, somewhere around L2/3 and C4-C6 interbody fusions.

    The pain is unbearable at times. Sitting, standing and walking are the worst. Please help!!

    Chiropractic treatment of slipped disc in neck

    Chiropractic treatment of slipped disc in neck would probably include some or all of the following:

    • Cervical spine manipulation
    • Axial traction
    • Home traction
    • Ice, perhaps with alternating heat
    • Soft tissue massage, including the Scalene muscles
    • Various electical modalities
    • Acupuncture
    • Exercises
    • Avoidance of carrying anything heavy in the affected arm
    • Avoidance of looking up, particular with rotation.

    More about Mr G

    I was insistent that he ceased with body building for a period, certainly his upper body, something he was only partly compliant with, to his detriment. Eventually he learned: "Those who will not hear, must feel."


    20-6-2011: T6 adjustment, cervical spine mobilisation and axial traction.


    23-6-2011: Some improvement, but a very weak feeling remains in the right arm. Tingling in the shoulder region with Kemp's Test. ULTT test R ++ still very positive. Tric R weak. Chiropractic rotatory adjustment C7R (no release), L (release), Half nelson adjustment of upper thoracic spine.

    Advice: Cervical spine X-rays. (Better and safer would be an MRI, but very expensive).


    28-6-2011: Definitely some improvement, but Upper Limb Tension Test (ULTT) and Kemp's test still positive. Same treatment.


    30-6-2011: Further improvement. Same treatment. Oblique X-rays show mild foraminal encroachment at C5-C6 and C6-C7.


    5-7-2011: Continuing improvement. ULTT is negative for the first time, and strength appears to be returning to the triceps and pec major muscles. Kemp's test does not radiate to the arm today.

    Add first exercises: Neaderthal.


    7-7-2011: Continuing improvement. Same treatment.


    14-7-2011: Set back after trying to do some light weights, and pull downs. Forbidden to do any upper extremity gym.


    21-7-2011: Again pain in arm after forbidden training! C7 Left with release. Half Nelson. Deep soft tissue in right trapezius muscles, and rotator cuff muscles, triceps.


    23-7-2011: Still very sore, especially at T3. Kemp's test pain bilaterally, but only in neck.


    26-7-2011: Improving again. Same treatment.


    23-8-2011: After a month's holiday, almost no neck or arm pain. Range of motion is good, Kemp's test is negative and ULTT is negative. Strength has returned to the triceps but wasting of triceps and Pec Major is still evident. Occasional tingling, now in thumb and forefinger (C6 dermatome).

    No manipulation today. Axial traction, cervical mobililisation and soft tissue work.

    The future 

    Whether Mr G can return to body building or not remains uncertain. Certainly a month away from his weights has done him a power of good.

    He's happy. I'm optimistic, but clearly it's the weak link in his chain... and another slipped disc in neck is quite possible.


    Return from SLIPPED DISC IN NECK to Slipped disc arm pain


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    Interesting challenges of the day

    1. Mrs B has had one of the nastiest of conditions; vertigo caused by a disturbance in the inner ear. Falling repeatedly and vomiting she consulted her doctor but medication didn't help. After two sessions of the Epley manoeuvres she was 50 percent better. After two weeks she was 75 percent improved; no longer vomiting or falling. She's not enjoying the Brandt Daroff home exercises.

    2. Mr S, a 48 year old man, has right low back pain, groin pain and a numb feeling in his lower leg when he sports. For six months he's been off football. He too has two problems; a very treatable lumbar facet syndrome and a very serious blocked artery in the groin; it's called intermittent claudication. Smokers beware.  

    3. Mr S looks like the leaning tower of Pisa; he has a slipped disc at L5 making him lean towards the opposite side. It's called the postero lateral disc hernia; we'll fix it, but he has to stop for a week or two. Antalgias are serious so take them seriously. 

    4. Mrs V too has two conditions; a chronic low grade sciatica giving her an ache in the right leg, and a threatening Morton's neuroma. She's glad I'm back in Holland; chiropractic fixed it before, and we'll fix it again. 

    5. Mrs W is one of the lucky ones, says her doctor. I agree. He says only 40% of patients with lumbar stenosis have a successful operation. We fixed a nasty slipped disc three years ago, but it came back two years later; the surgeon did a fine job but she has a weak ankle now giving her subtalar joint pain; it's routine stuff. 

    6. I myself had an acute exacerbation of a femoral nerve lesion last year. One immediate treatment of the new strain by my colleague has fixed the pain in the lower back, but there's some residual numbness in the lower leg; no soaring tomorrow alas.

    7. This lady is a 86 year old woman with a 63 scoliosis. Chronic lower back has been her lot in life but she's well pleased with chiropractic and comes for chiropractic help once a month; some conditions you can never cure.

    8. She is an 78 year old woman, is doing remarkably well with a bad sciatica. But over 200 pounds she is not losing weight; in fact, gaining despite my suggestions. She's high risk for a stroke. I have referred her to a dietician to crack the whip.

    9. A 61 year old man with upper cervical pain yesterday; it's not severe but also not getting better of its own accord. He's afraid it may turn very acute as when I treated him three years ago. Since then it's been fine. 

    10. A 64 year old woman has had scheuermanns disease; it's left her with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment provides she come every six weeks or so for maintenance treatment.

    11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

    12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.

    13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

    And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

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    Interesting questions from visitors

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    Greetings, Dr B.
    You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

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    Brachial plexus

    Arm pain

    1. Shoulder

    Frozen Shoulder

    Rotator cuff

    "My thumb, forefinger and middle finger went weak after cuff surgery."

    "Hello John, I take it you've been back to the surgeon.

    It's probably temporary inflammation of the median nerve, but of course could be worse... I'm afraid I don't think chiropractic has anything to offer at this stage.

    Once everything has healed up, if you don't get the strength back, or your fingers remain numb and tingly, then I'd consult a local chiro to see if there is also a problem in your neck or the first rib.

    Dr B"

    Letter from reader looking for advice.

    2. Elbow

    Elbow pain

    3. Wrist

    How bad is your arm shoulder hand pain?