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I Have Cervical Disc Disease Does Physiotherapy Helps

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Posted on Wed, 4 Oct 2023
Question: I continue to have neck pain on my right side .. the doctor says I have cervical disc disease in several locations on the neck.. is this due to a bad whiplash I had 30 years ago.. I also fell in a hole last year. .. I had knee pain on the hole accident but no neck pain.. I am doing massage hot compresses and exercises given to me by a physical therapist but I do not like to take medicine.. is it doing me more harm by not taking the antiinflammatories??? Also how many people does it lead to nerve compression and more pain.. I am worried with this diagnosis .. will it be a big disability for me in the future??? I am an active 70 year old.. did stress bring this on?? Thanks so much!!!!
doctor
Answered by Dr. Olsi Taka (3 hours later)
Brief Answer:
Trauma may play a role, not taking antiinflammatories will not harm you.

Detailed Answer:
I read your question carefully and I understand your concern.

Degenerative disc disease is a very common issue, it is related to the wear and tear the spine has to endure over many years so naturally it is more likely to be found with age. Apart from age, other factors would include heavy physical work, genetic predisposition and trauma. So trauma like the the whiplash and fall you mention may play a role, however they can't be held as the only causes, it is a combination of several factors as I said, not a sinle one. Not stress though, it is not a cause.

Anti-inflammatories do not change the course of the condition much, they do not reverse the changes on the spine over the years. So you aren't doing yourself more harm by not taking them. What they do is alleviate (or at least try) the pain which is bothering you. Other means like physical therapy exercises while very important in the long term do need some time to show their effects, so for the moment anti-inflammatories are the best means to temporarily alleviate the pain. Not taking them though won't lead to more harm,no additional nerve compression and pain, do not fear that.

As for whether it will cause a disability in the future, as I said it is a very common issue, a chronic one, meaning it can't be reversed and it will bother you from time to time, there will be periods of flaring of the pain. However usually with physical therapy patients are able to lead normal lifes without major symptoms and disability most of the time. It is only in rare cases that symptoms do not gradually subside and other means like local injections or surgery may be considered.

As for viewing the images, yes we can assess them. You mention only X-ray though, is that the only test you've had. X-ray can show changes in the vertebrae, but it doesn't provide a complete picture. To assess disc changes, whether there is nerve compression or compression of the spinal cord an MRI is necessary. If that is what you had then would gladly view it, but you have to upload the whole test which is comprised of many images (hundreds at times). If you're not able to do that perhaps you can upload only a copy of the full radiologists report.

I remain at your disposal for other questions.
Thanks.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Olsi Taka (59 minutes later)
Thank you for your very detailed reply!! I appreciate you so much as I try to understand this new diagnosis.. I only had the X-ray but they were able to pick up the narrowing of several discs on he X-ray.. does that show it is more severe? Or are The new digital X-rays able to pick up more detail than they used to.. a pt told me that it must be pretty severe if the X-ray picked up on it.. that really added to my anxiety!! I also had a c reactive protein test and it was in the normal range.. does that mean I have little inflammation? Thank you sooo much!! You are a wonderful doctor!!!
doctor
Answered by Dr. Olsi Taka (2 hours later)
Brief Answer:
Read below

Detailed Answer:
Thank you for the added info.

An X-ray is a test which visualizes the bones, the vertebrae, to exclude fractures, to show arthritic changes of the bones, abnormal curving of the spinal column and bony spurs. It can provide some indication on your discs but in an indirect manner, not visualizing them directly, even the newer x-rays. So from your description it shows that the distance between the vertebral bodies (where the discs are situated) is smaller than usual, thus indicating that the discs have lost volume which usually happens due to their losing water, drying out. I wouldn't say it shows it's more severe, with age it is a process which is bound to happen in most people sooner or later. However that is as far as the x-ray goes, showing the presence of these age related changes. However when it comes to understanding whether this "drying out" of the discs is associated with displacement and disc bulges which may cause nerve compression or spinal cord compression the x-ray doesn't visualize those structures, the MRI is the exam of choice to visualize the discs, nerves and spinal cord and their relationship to each other.
Whether you absolutely need a MRI that depends on clinical manifestations. If the pain is limited to the neck, not spreading to the upper limb to indicate nerve pinching, if the physical examination by your doctor doesn't show abnormal reflexes or muscle weakness to indicate spinal cord compression, then I wouldn't call MRI absolutely necessary. Since there isn't an indication of such compression raising the possibility of needing surgery it wouldn't change management much, it would remain based on physical therapy and pain medication when needed.
C-reactive protein being normal is a positive thing as it indicates that the issue is limited to the spine, with the age related changes with some local inflammation and not in the setting of a systemic disease like rheumatoid arthritis or lupus which cause much mor pronounce changes and also involve other organs apart from the joints.

As for working out with weights it is not advised as it would increase the load that the spine would have to bear and may increase muscle spasms which are a common contributor of the pain. Should limit to exercises as instructed by your physical therapist which aim to stretch your muscles and strengthen your core, your spine muscles in order to ease the load carried by the spine.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Olsi Taka (5 hours later)
You are amazing thanks so much! I would love to be your patient..you explain things so well!!! Thanks again for your answers that were so detailed and easy to understand!!! Bless you doctor!!!
doctor
Answered by Dr. Olsi Taka (2 hours later)
Brief Answer:
Thank you!

Detailed Answer:
Thank you for your kind words. Glad to have been of help.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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I Have Cervical Disc Disease Does Physiotherapy Helps

Brief Answer: Trauma may play a role, not taking antiinflammatories will not harm you. Detailed Answer: I read your question carefully and I understand your concern. Degenerative disc disease is a very common issue, it is related to the wear and tear the spine has to endure over many years so naturally it is more likely to be found with age. Apart from age, other factors would include heavy physical work, genetic predisposition and trauma. So trauma like the the whiplash and fall you mention may play a role, however they can't be held as the only causes, it is a combination of several factors as I said, not a sinle one. Not stress though, it is not a cause. Anti-inflammatories do not change the course of the condition much, they do not reverse the changes on the spine over the years. So you aren't doing yourself more harm by not taking them. What they do is alleviate (or at least try) the pain which is bothering you. Other means like physical therapy exercises while very important in the long term do need some time to show their effects, so for the moment anti-inflammatories are the best means to temporarily alleviate the pain. Not taking them though won't lead to more harm,no additional nerve compression and pain, do not fear that. As for whether it will cause a disability in the future, as I said it is a very common issue, a chronic one, meaning it can't be reversed and it will bother you from time to time, there will be periods of flaring of the pain. However usually with physical therapy patients are able to lead normal lifes without major symptoms and disability most of the time. It is only in rare cases that symptoms do not gradually subside and other means like local injections or surgery may be considered. As for viewing the images, yes we can assess them. You mention only X-ray though, is that the only test you've had. X-ray can show changes in the vertebrae, but it doesn't provide a complete picture. To assess disc changes, whether there is nerve compression or compression of the spinal cord an MRI is necessary. If that is what you had then would gladly view it, but you have to upload the whole test which is comprised of many images (hundreds at times). If you're not able to do that perhaps you can upload only a copy of the full radiologists report. I remain at your disposal for other questions. Thanks.