07/10/2013 // Concord, CA, USA // LifeCare123 // Greg Vigna, MD, JD // (press release)
The treatment of neck and arm pain related to cervical herniated discs in the majority of patients is conservative. Surgical management is reserved for those with intractable pain and those with progressive neurologic deficits causing weakness. Cervical disc herniation occurs with forceful flexion, rotation, and extension of the neck commonly seen in whiplash injuries from motor vehicle accidents. Ninety percent of all cases are at the C5-6 and C6-7 levels. Patients often complain of a ‘crick in the neck’ with decreased mobility of the neck, arm pain, numbness, and weakness.
Cervical traction has been shown to decrease the pressure within the disk that presses on the nerve roots and stretches muscles that are in spasm. It is believed that traction breaks the ‘circle of pain’ by taking the pressure caused by the disc herniation itself or inflammatory swelling off the nerve root that causes muscle spasms which further increases the pressure on the disc. Five pounds of intermittent traction twice a day for as brief a time as five minutes have been proven valuable even in large volume herniated discs.
Traction can be applied manually to a patient by a physical therapist while lying flat on their back and also by way of a variety of mechanical apparatuses that . From my experience the easiest home traction unit is simply one that hangs over a door and utilizes water as the source of weight. I encourage patients to use the device while relaxing watching television. Frequency and duration will depend on their symptoms. Pain relief is rather impressive both in terms of neck pain and arm pain. Combining this treatment with anti-inflammatories and muscle relaxants appears to augment the improvement.
It is not uncommon for patients to return 5 to 8 years later to my office for an unrelated reason stating that they have intermittently utilize the same home traction unit for reoccurrence of their discomfort over the years with continued and consistent improvement. That certainly beats medications, doctor’s visits, injections, physical therapy, and surgery.
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