A bulging disc or herniated disc in the C4-C5 level of the cervical spine can affect the nerves that control the arms, hands, shoulders, neck, head, chest, eyes, and many other parts of the body. Symptoms can vary from person to person but common symptoms of C4-C5 herniated discs include arm pain, tingling and numbness or burning that may radiate into the fingertips.pinched nerve in neck C4-C5 herniated disc, bulging disc in neck causes pain and tingling
Usually, a C4-C5 bulging disc or herniated disc is caused by some type of injury or trauma such as a car accident, fall, sport injury or work injury. A C4-C5 herniated or bulging disc can also occur from deterioration that occurs in the disc over time. The discs may deteriorate from wear and tear or because of degenerative disc disease causing a weak outer layer of the disc, or annulus fibrosis, which can cause a C4-C5 bulging disc over time.
The C4 and C5 vertebrae are the primary members of the mid-cervical spine. These two members are the most mobile in the mid-neck, and they support most of the forward and backward movements of this section of the neck. Therefore, they are prone to motion-related injury and disorders like disc herniation.
The C4 and C5 vertebrae are part of the C2-C5 motion section of the neck. The neck vertebral column, otherwise known as the cervical spine, has seven member vertebrae numbered from C1 to C7. The C2-C5 section of the cervical spine constitutes the mid-neck. Of this entire section, C4 and C5 are the two most mobile members, although they do not experience as much motion as the lower cervical spine segments, i.e., the C5-C8 motion segment.
These two intervertebral members are connected via paired facet joints and the C4-5 disc. These joints traverse the entire length of the spine. Typically each facet joint is synovial in nature and contains articulating cartilage that aids smooth gliding motion between the connected members.
The C4 and C5 are also separated by an intervertebral disc termed the C4-C5 disc. This disc serves the function of cushioning the vertebrae and absorbing any shock or sudden impact. It also aids the flexibility of the cervical spine, allowing it to bend easily and move in all directions. Normal discs do not cause pain.
Due to its location in the middle of the neck, the C4-C5 disc is not as prone to herniation as other intervertebral discs located in the lower cervical spine, e.g. the C5-C6 or C6-C7 disc. However, the C4-C5 disc is more likely to be damaged than other discs in the C2-C5 motion segment, such as the C1-C2 and C2-C3 discs.
Conditions such as degeneration of outer disc tissue, injury, and trauma can compromise the integrity of the C4-C5 disc and cause it to herniate. This herniation occurs when the nucleus pulposus of the disc is squeezed into the nerve canal through a tear in the annulus fibrosus. The annular tear is the actual source of neck pain and inflammation in the posterior annular tear is the actual anatomical source.
Without inflammation, there is no neck pain. The painful annular tear at the back of a herniated C4-5 disc can be repaired with a minimally invasive endoscopic procedure called the Deuk Laser Disc Repair.
Herniation of the C4-C5 disc usually leads to inflammation of the C5 nerve root. This inflammation occurs when the herniated material of the C4-C5 disc impinges onto the C5 nerve root and causes it to become irritated. The C5 nerve root is the spinal nerve that controls most of the movement and sensations in the shoulders, upper arms, and forearms. Hence, any disturbance caused to this nerve root affects the sensory and motor abilities of the aforementioned parts of the upper body. The C5 nerve root also has branches that extend into the phrenic nerve, which encloses the diaphragm and allows normal breathing.
The C4-C5 cervical disc supports neck motion while also protecting the C4 and C5 vertebrae from trauma. As a result, natural wear and tear can begin to develop over time. The cartilaginous ligaments that attach the disc to the vertebrae may become less flexible over time, leading it to rupture at the slightest provocation.
A cervical disc herniation is most commonly caused by trauma or injury to the cervical spine. Herniated discs are common, and they become more commonplace as people get older. Herniated discs cause symptoms in less than 2% of the population each year, with most cases occurring in young adults and middle-aged people. The C2-C5 motion segment, which includes the C4-C5 disc, is prone to damage which can cause degeneration, disc herniation, trauma, or neurological impairment.
Compression of the spinal cord in the C2-C5 motion segments can result in spinal cord dysfunction leading to weakness, or paralysis in the arms and/or legs. In some circumstances, bowel and bladder control may be lost.
Pain caused by C4-C5 disc herniation can appear immediately after an accident. Likewise, it can build over time, especially when the disc is affected by degeneration. In either case, the head, neck, shoulder, and arms are usually the most affected by the pain.
The severity of this pain will typically range from moderate to severe causing major alterations in a person’s daily routine. There is also the possibility of the patient developing cervicogenic headache, which is caused by pain radiating from the upper neck into the back of the head. If this is the case, any movements of the neck and arm may increase the pain. One or more regions of the forearm, hand, and/or one or more fingers may also lose normal sensations and become numb.
Other symptoms of C4-C5 disc herniation can include weakness in one or both shoulders, elbows, and wrists. Joints in these locations are also likely to be affected, hence limiting motions. In rare cases, the branches of the C4-C5 nerve located in the phrenic nerve may be affected and become inflamed. This will have an adverse effect on the diaphragm, and patients may experience difficulty breathing.
Nonsurgical treatments are usually used to treat pain and minor symptoms in the C2-C5 spinal mobility segments. In extreme cases, patients might develop neurological impairments, such as paralysis and bowel/bladder control loss. When such symptoms are observed, surgery becomes a necessary course of action.
One of the most common non-surgical means of herniated disc treatment is cervical traction. Traction is a pain-relieving technique that involves stretching and realigning the spine. A therapist can do the stretch manually or with the use of spinal traction equipment. This treatment relieves spinal nerve compression by opening up the neuroforamina.
When considering surgery, it is essential to note that the C2-C5 motion segments can be operated from either the front or back of the neck. Some procedures can be done using a combination of both methods. Surgery usually involves reducing the compression on the nerve and eliminating the pain caused by the herniated disc. Patients should be aware that some surgical options carry more risk of complications than others. These complications could include infection or excessive blood loss and often tend to compromise the integrity of the spine and general patient wellbeing.
Physical therapy is one of the most suitable ways to improve the condition of the cervical spine. Sessions should always be conducted with a qualified physiotherapist to avoid worsening the injury and pain. However, such a course of treatment should only be undergone when the patient has no underlying medical conditions or dilapidating spinal injury.
When physical therapy is determined to be suitable, methods like ice packs, heat therapy, massage therapy, ultrasound, electrotherapy, and other passive therapeutic modalities are offered. The purpose of passive physical therapy is to aid in the reduction of pain and edema.
Active physical therapy can also be incorporated into the treatment regimen to improve the strength of the cervical spine. These mainly include stretches and exercises designed to ease neck pain and maintain better posture.
At Deuk Spine Institute, we specialize in minimally invasive surgical techniques and comprehensive spine treatments to cure back and neck pain. Our world-class physicians are personally invested in the well-being of every patient. Start your treatment with us today by submitting your MRI online for a free remote review to determine your candidacy for surgery. You can also visit one of our locations in person by calling patient services at 321-255-6670.