"How Serious Is A Herniated Disc In The Neck?"
by Dr. Benjamin Geddes

Yeah, there's a couple of varieties for a herniated disc. The most common variety is where the disc herniates and it pushes on one of the existing nerves. And that's not an emergency in the sense that you're going to be paralyzed. It’s some of the things that we all worry about related to the spine. In that situation, it typically is more of a quality of life thing. You know how much pain are you in and how debilitating is that for you in terms of being able to work and function and do normal stuff? Numbness is also in that same category.

Occasionally you do get true weakness. It wouldn't be paralysis in that case, but it would be a particular muscle group that was related to the nerve that's being pinched. And in that case, typically, we don't like to sit on that for too long. We certainly would try conservative measures even in that scenario. But we wouldn’t want it to go beyond, you know, several weeks to months before we said something probably should be done in order to try to assure that the strength comes back over time.

There is a less common scenario, which is where the discrimination actually pushes on the spinal cord itself. It causes a different set of symptoms. It's called cervical myelopathy, and that presents differently. You can have arm symptoms in some of the other symptoms for the pinched nerve. But typically it's dexterity issues. It's hard to use your hands. It's hard to button your shirt. Your handwriting changes. You may have frequent falls because your coordination in your lower extremities is off.

And in that case, myelopathy is something where we don't recommend conservative treatment because typically people just slowly get worse. It's not like instant paralysis or something acute like that, but over time you tend to get worse and kind of plateau and then get a little bit worse and plateau, and it never really gets better. So if you can intervene earlier, it's better in terms of your overall functional outcome. So in that case, it is more of an urgency for sure.