Cervical Disc Herniation and Pain Management Options

Q: Cervical Disc Herniation and Pain Management Options

Hello： Nerve compression can cause pain. <br>Treatments such as acupuncture or heat therapy may help alleviate the pain and discomfort, but these are only symptomatic relief and not a fundamental solution. <br>It's likely that the symptoms will recur in a short period of time. <b

Cervical disc herniation issues?

My mother experienced severe pain in her left arm six months ago, requiring steroid injections for pain relief.
An X-ray indicated the presence of bone spurs in her neck, and further MRI was recommended.
Unfortunately, in early September, she suffered a rupture of a cerebral aneurysm and went into shock, but she was discharged at the end of November and is currently rehabilitating at home.
In early December, she suddenly reported significant pain in her left arm again.
An emergency MRI revealed a herniated disc at the C3-C4 level and spondylolisthesis at the C4-C5 level.

My mother has been frequently visiting a traditional Chinese medicine practitioner for acupuncture and has been using a cervical collar and heat therapy.
So far, she claims that the pain has subsided.
However, we have consulted three major hospitals (bringing along the MRI disc), and the doctors all stated that her condition is serious and requires surgery.

Why has her pain diminished after acupuncture, heat therapy, and using a cervical collar? Is it possible that the pain has transformed into numbness, which she may not be able to perceive due to her stroke? After observing her for several days, she does not seem to exhibit any signs of discomfort.
Should we continue with acupuncture, heat therapy, and the cervical collar and postpone surgery? Typically, wouldn't nerve compression cause pain? Why has the pain suddenly disappeared? Thank you for your response!

Xiao Ke Ai, 30~39 year old female. Ask Date: 2015/12/26

Dr. Zhang Junwei reply Neurosurgery

Hello: Nerve compression can cause pain.
Treatments such as acupuncture or heat therapy may help alleviate the pain and discomfort, but these are only symptomatic relief and not a fundamental solution.
It's likely that the symptoms will recur in a short period of time.
Surgery remains the most definitive way to address the problem.

Reply Date: 2015/12/26

More Info

Cervical disc herniation is a condition that occurs when the soft material inside a spinal disc in the neck bulges out and presses on nearby nerves. This can lead to pain, numbness, or weakness in the arms, shoulders, and neck. In your mother's case, her symptoms have been quite severe, leading to steroid injections and multiple medical evaluations. The MRI findings of disc herniation and vertebral slippage (spondylolisthesis) indicate significant structural issues in her cervical spine.

The fact that your mother has experienced relief from pain after acupuncture and heat therapy is not uncommon. These treatments can help alleviate pain by improving blood circulation, reducing muscle tension, and promoting relaxation. Acupuncture, in particular, has been shown to be effective for some patients with chronic pain conditions. However, it is essential to understand that while these treatments may provide symptomatic relief, they do not address the underlying structural problems caused by the herniated discs or vertebral slippage.

The decision to proceed with surgery is typically based on several factors, including the severity of the symptoms, the degree of nerve compression, and the impact on the patient's quality of life. In cases where conservative treatments (like acupuncture, physical therapy, and medication) do not provide sufficient relief, or if there is significant neurological impairment, surgery may be recommended.
It is also possible for symptoms to change over time. For instance, if a nerve is compressed, it may initially cause pain, but if the nerve becomes severely damaged, it might lead to numbness or weakness instead of pain. This could explain why your mother is experiencing less pain now; however, it is crucial to monitor her condition closely. The absence of pain does not necessarily mean that the underlying issue has resolved.
Given your mother's history of a brain aneurysm and the complexity of her current condition, it is vital to maintain open communication with her healthcare providers. If she is feeling better, it may be tempting to delay surgery, but it is essential to weigh the risks and benefits carefully. Regular follow-ups and imaging studies may be necessary to monitor her condition and ensure that no further complications arise.

In summary, while acupuncture and heat therapy can provide temporary relief from pain associated with cervical disc herniation, they do not replace the need for a thorough evaluation and potential surgical intervention if warranted. It is advisable to continue consulting with her medical team, considering both her current symptom relief and the potential risks of delaying surgery. If her symptoms change or worsen, it may necessitate a reevaluation of her treatment plan.

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