Disc injury is a common source of neck pain associated with radiation of pain into the upper back, shoulder, and arm.

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Disc Injury - Neck, Shoulder, and Arm Pain Disc injury is a common source of neck pain associated with radiation of pain into the upper back, shoulder,

Discs are a two part structure a gel nucleus surrounded by a series of dense annular rings.

1 Disc Injury - Neck, Shoulder, and Arm Pain Disc injury is a common source of neck pain associated with radiation of pain into the upper back, shoulder, and arm. Intervertebral Discs, located between the spinal vertebrae, are the weight bearing organ of the spine. Discs are a two part structure a gel nucleus surrounded by a series of dense annular rings. Disc Injury: Most disc injuries develop over time and are due to poor posture, particularly poor seated posture.the most common example of poor posture is the head forward, slouched shoulder position found in sitting, working at a desk or computer, or driving.

Poor seated posture causes displacement of the disc nucleus from the center to the rear producing injury to the posterior disc wall. There are three levels of wall failure.

2 Poor seated posture causes displacement of the disc nucleus from the center to the rear producing injury to the posterior disc wall. There are three levels of wall failure. A partial failure, in which the wall weakens but remains intact, allows the nucleus to bulge outward resulting in an acute, painful episode of neck pain. If the annular wall tears completely, disc material may protrude through the annular rings creating a disc herniation. In the most severe case, nuclear gel may extrude through the wall and break free, becoming a loose fragment. All three of these events a bulging disc, a herniated disc, or an extruded fragment result in severe neck pain and, if the disc material presses on the spinal cord or a root of a brachial nerve, may also cause referred pain to the shoulder and/or shoulder blade and radiating pain of through the entire arm to the fingers.

3 Acute Care of an Injured Cervical Disc: The vast majority of cervical disc injuries can be treated successfully with corrective exercises and by following a few simple rules of posture during daily life. Surgery is almost never required. The first goal of treatment is to relieve the inflammation and swelling in the disc and brachial nerve roots and branches. Rule #1: Avoid slouching postures - when sitting at a desk or when driving, when resting, watching television, reading, etc. Rule #2: Avoid positions in which the arm is elevated, which can compress the brachial nerves; and, positions in which the arm is hanging, which can stretch the brachial nerves. Rule #3: Avoid positions in which the shoulders are held in an elevated position - don t wear your shoulders as ear muffs! Rule #4: Do the basic postural exercises hourly, especially as a correction when you notice that Rules 1 thru 3 have been broken. Rule #5: Frequent use of ice and anti-inflammatory meds through the day. In severe cases, it may be necessary to wear a cervical collar and/or an arm sling for a short period of time to avoid creating further inflammation and swelling.

Corrective Exercises: The first corrective exercise for disc swelling is called retraction of the neck and jaw. This exercise builds the Core muscles of the neck, the deep neck flexors.

4 Corrective Exercises: The first corrective exercise for disc swelling is called retraction of the neck and jaw. This exercise builds the Core muscles of the neck, the deep neck flexors.viewed from the side, retraction looks like making a double chin. In the retracted position, the nucleus is recentered, relieving the swelling of the disc and the pressure on the brachial nerves. At first, it is easiest to practice retraction while lying down in bed. With the pillow removed, practice dropping the chin and jaw into the hollow of the throat and pressing the entire neck and head down into the mattress. When the basic retraction exercise is mastered, practice retraction in the seated and standing positions.

Once the first exercise is mastered, practice retraction with

From the seated position, retract the chin to its end point (A).

neck flexors as part of the long chain of extensor muscles using

5 Once the first exercise is mastered, practice retraction with elevation. From the seated position, retract the chin to its end point (A). Next, allow the chin to elevate slightly and retract the chin to a new end point (B)(C). In this exercise, it is as if your neck is climbing a staircase in reverse. (A) (B) (C) If you have the equipment available, exercise the deep neck flexors as part of the long chain of extensor muscles using the Roman Chair. Starting in full flexion, retract the chin and neck to the end point (1), then continue to arch the spinal extensors (2). Continue contacting the spinal extensors until the spine is fully arched (3). (1) (2) (3)

The next corrective exercise involves strengthening the lower division of the trapezius muscle.

To begin, shrug the shoulder blades directly up - then forcefully shrug the blades straight downward.

Standing in an open doorway, place the entire forearm against the doorjamb.

6 The next corrective exercise involves strengthening the lower division of the trapezius muscle. A good way to visualize this action is to imagine a downward shrugging of the shoulder blades. To begin, shrug the shoulder blades directly up - then forcefully shrug the blades straight downward. To open the chest, do the doorway stretch for Pectoralis major. Standing in an open doorway, place the entire forearm against the doorjamb. Lunge into the opening, slightly rotating the spine away from the elevated arm. Try varying the height of the arm to effect different fibers of the Pectoralis. Dr. Tuck Kantor 225 Main Street Westport, CT drtuckkantor@optonline.net

Disc Injury, Lower Back Pain and Sciatica

Disc Injury, Lower Back Pain and Sciatica Disc injuries are the most common cause of lower back pain and sciatica, the sharp, shooting pain that radiates from the lower back into the buttock, thigh, and