Introduction
A herniated disc in the cervical spine is not a rare form of herniated disc and is often accompanied by restrictions in the shoulder-arm region. Often the cause of a herniated disc in the cervical spine is not exclusively limited to the cervical spine itself, but also stems from postural defects in the thoracic spine. These should therefore always be included in the exercise program.
In the case of a slipped disc in the cervical spine, disc tissue has leaked and now irritates the surrounding structures, for example, leaking nerve fibres. These cause pain in the periphery, for example in the shoulder or upper arm. Paralysis and sensory impairment can also occur, which can be treated in physiotherapy. You can find more extensive information on this topic on our main page Slipped disc of the cervical spine
Mobility of the cervical spine
The cervical spine is a very mobile section of our spine. It can be turned (rotation) when we try to look back over our shoulder or when we shake our head. It can be tilted to the side (lateral flexion) while we try to move our ear towards the shoulder.
It can be bent and stretched (flexion and extension) when we nod, for example. This range of movement can be limited by a herniated disc but should be regained as completely as possible. Often a herniated disc is caused by increased protraction, i.e. pushing the chin forward while simultaneously placing the head in the neck.
Often we take this position in front of the computer. During this movement, the front structures of the cervical spine are stretched and the back structures are compressed. For both sides is a load on the structures.
Physiotherapy
After a herniated disc in the cervical spine, physiotherapy is essential. It can help to correct the malposition of the spine and strengthen the muscles in the cervical region. The physiotherapist can perform certain exercises and also show exercises that can then be done at home.
Gymnastics
In order to relieve the herniated disc, the physiological natural head position should be practiced and protraction should be reduced. To do this, you practice the retraction, i.e. the opposite way to the protraction, where you try to make a double chin and stretch the rear cervical spine far upwards, the vertex striving towards the ceiling. At first you should exaggerate this position a little bit and then go out of the position by about 10%.
Here is about the normal position of the spine. It is a good idea to do this exercise in front of a mirror. When the straight upright position of the spine is mastered, you can continue with gymnastic exercises.
A training for the front cervical muscles is a very simple exercise. The patient lies straight on the floor in the supine position without a pillow. He goes into a slight retraction position by pulling his chin slightly towards his chest and stretching the back of his neck.
Now you try to lift the head slightly off the floor. As if you want to look at his belly or knees. It is a very small movement that takes place, sometimes it is enough to guide it through the eyes and only support it with a minimal lifting of the head.
The head moves only a few millimetres away from the ground. The position is held for 5-10 seconds and then the tension is slowly released. It can be repeated up to 10 times.
Later, when the first progress is noticed, the loading time can be increased. It may be that the exercise is uncomfortable at the beginning. Our front neck muscles are usually very weakened and can no longer stabilize our head well.
We want to improve this with this exercise. The unpleasant feeling should decrease with time. The retraction position itself can often also be used as a good exercise for a herniated disc in the cervical spine.
As with all exercises, a good evaluation of the patient before creating an individual exercise program is essential, because every patient is different and possibly different structures are affected by the herniated disc. For the retraction exercise the patient takes the chin strongly towards the chest. The vertex stretches upwards.
One can either simply hold the position for a few seconds or strengthen it by applying light pressure to the chin. The position is held for about 5-10 seconds and then slowly released. If you increase the exercise by applying pressure to the chin, you should gently build up the pressure.
It is best to place the distance between thumb and index finger on the chin and try to keep the forearm parallel to the floor to avoid lever movements. Now you put a slight overpressure into the retraction. There are many variations of the retraction exercise, resistances can be set, e.g. with a towel or even the headrest in the car or it can be done manually by the therapist.
An intensive stretching program is also part of the gymnastic exercises for a slipped disc in the cervical spine. By adopting maximum lateral inclination, stretching can be achieved in the opposite cervical area up to the shoulder. The stretching position can be intensified by applying slight pressure on the head with the arm to whose side the head is inclined.
Please only put the weight of the arm on the head, do not pull because the cervical spine is sensitive. It is important that the shoulder does not pull up on the side that is being stretched. It is best to consciously press the hand of the arm towards the floor or hold on to the edge of a chair.
The stretching position should be held for about 20 seconds and can then be slowly released. Rotation components can also be included in the stretching program, depending on the shortened muscles. In the case of a slipped disc in the cervical spine, the thoracic spine should also be taken into account.
Frequently, an increased hunchback in the thoracic spine is compensated by a protraction in the cervical spine. If this is the case, the straightening of the spine should also be considered in the gymnastic exercise program. A variety of exercises are available for this purpose. Therabands can be used to help. In all exercises it is important to constantly check the position of the cervical spine in order to avoid damaging positions that put additional strain on the area of the herniated disc.
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