Center for Pain Management

Cervical Radiculopathy

Between each spinal segment (vertebrae) there is a soft disc that allows for movement between the segments and provides some shock absorption. The disc is made up of fibrous outer layers (annulus) surrounding a gel like center (nucleus pulposus). When there is weakening of the outer layers, the disc can bow out or bulge toward the nerve root as it exits the spinal canal. This is referred to as a bulging disc. When there is tearing of the annulus with progression of the nucleus toward the perimeter of the disc that is called a herniated disc. If the gel ruptures through the outer layer of the annulus, that is an extruded or ruptured disc. The radiating pain that can result from theses disc problems comes from the disc material compressing or chemically irritating the nerve root. This is called a radiculopathy.  Some disc bulges and herniations do not cause any pain if the nerve root is not affected. In other cases the patient experiences pain coming from nerve endings within the outer layers of the disc itself. This is diagnosed as internal disc derangement. The process by which the discs become less hydrated and elastic throughout the aging process is referred to as degenerative disc disease. It is not in fact a disease but a part of the aging process of the spine. This causes the discs to loose some of their height placing increased stress on the bony structures.