For appointments or confidential discussion call
London Clinic 07776 511824
Norwich Clinic 01603 505063

The London Norwich Spine Clinic is based at
Hospital of St Johns & St Elizabeth, St Johns Wood, London
and the Spire Norwich Hospital, Norwich.

Information for GPs

Your spine is one of the most important and complex parts of your body - keeping it healthy is vital if you want to lead an active and pain free life.

Cervical Disc Herniation (Neck)

Also called a 'slipped' disc or a 'disc prolapse', this is a tear in one of the discs that cushion the vertebrae and allow the neck to move comfortably.

This tear in the fibrous exterior of the disc allows the soft central fluid to leak out, putting pressure on the spinal cord and nerves that supply the arms and legs.


  • Repetitive activities
  • General wear and tear
  • Injury
  • Ageing - flexibility in spinal discs reduces with age so they can tear more easily
  • Genetics - some people inherit a higher tendency for their discs to tear


  • Neck pain (may be general dull ache or severe burning and localised pain)
  • Radiating arm and shoulder pain
  • Sensory changes - numbness, pins and needles, weakness and tingling in the arm or hand
  • Difficulty walking because of poor co-ordination


  • Physical examination to assess the neck, arms and lower extremities for flexibility, range of motion and other signs that suggest a herniated disc
  • X-rays, CT scan or MRI scan may also be needed to assess site and damage in more detail

Treatment options

The majority of herniated discs heal themselves in the first six weeks so conservative treatment can be effective.


  • Painkillers
  • Physiotherapy
  • Lifestyle changes - such as losing weight and changing working conditions
  • Injections to help ease arm pain


When there is progressive pain that is difficult to manage or arm and leg weakness, surgery may be required. There are several methods that can be used depending on the nature of the herniation.

A discectomy removes the bulging disc material that is causing the pressure on the spinal cord or nerves (hence the term decompression surgery). Sometimes the disc may be removed entirely and the vertebrae either side are grafted or fused together to restore stability. Alternatively the disc may be replaced it with an artificial one.

This can usually be done in a minimally invasive way via a small incision. Most patients will go home the same day or next day and pain relief is usually immediate.

"I didn't realise how much pain and discomfort I was tolerating until it all went away. A month later, I spent a whole day teaching my god-daughters to sail. I felt like a new person. My whole life has changed
for the better." Read case studies >

Case studies

Mr F, aged 71

Condition: Cervical herniation

Treatment: Cervical decompression and fusion

The patient's experience:

"I had always been fit and healthy and loved sailing and swimming. However, over the course of a year I got increasing pain in my neck, shoulders and back. I also developed pins and needles and numbness in my right arm and leg.

The pain was so bad I was swallowing painkillers like sweets to deal with it.

Just before I saw Mr Rai I could barely move my head to the left which meant I couldn't drive properly. I had to ask my wife to look for me when I was turning right. I was miserable.

I saw Mr Rai two weeks after referral from my doctor. Following an MRI scan I was told my spinal cord was being restricted and compressed - and this was clear to see on the scan pictures.

Mr Rai explained that my condition was unlikely to improve with conservative treatment and likely to progress. Delaying wasn't an option either because it could only halt deterioration by that point and not reverse the damage. So I went ahead with surgery immediately.

Five days after the operation most of the aches and pains had gone, just some muscular soreness as the body re-adjusted. I didn't realise how much pain and discomfort I was tolerating until it all went away.

A month later, I spent a whole day teaching my god-daughters to sail. I felt like a new person. My whole life has changed for the better."

Mr L, aged 53

Condition: Cervical herniation

Treatment: Disc replacement

X-ray showing neck

Mr Rai's notes:

The first operation was a disc fusion of the vertebrae either side of the worst prolapsed disc. The second replaced the disc. I have been carrying out disc replacement surgery for 10 years in selected patients. This type of operation is only recommended in younger and middle aged patients who have movement in the disc above.

The patient's experience:

"I had suffered from rheumatoid arthritis for six years. However, three years ago my neck and shoulders became terribly painful and some of my fingers felt numb. I'd worked on offshore platforms for 20 years, but I couldn't manage any longer because of the pain and had to transfer to shore work.

An MRI scan showed two discs in my neck had prolapsed and one was much worse than the other.

Mr Rai carried out a disc fusion operation on my spine and this reduced pain in my shoulders and restored the feeling to my fingers.

However, just a year I felt the same familiar symptoms again ruining my work and social life. Apparently, it was the adjacent disc. Now I needed a disc replacement because fusing the next two vertebrae as well could stop me moving my neck properly in future.

I didn't feel that uncomfortable after the operation and I was fully recovered and back at work a few weeks later.

I have had no further pain and have full flexibility of my neck. I am able to continue working twelve hour shifts and on my days off I frequently cycle up to 40 miles with no ill effects."

Mr F, aged 73

Condition: Cervical herniation

Treatment: Injections

Mr Rai's notes:

I suggested treatment with injections as these are safe and have a low complication rate. They are designed to reduce inflammation and pain. This then allows the physiotherapist to further rehabilitate the patient by improving muscle function around the spine.

The patient's experience:

I had suffered with back pain for years and it had grown steadily worse. Two years ago, I had an operation on my upper spine, which cured the problems in my neck.

But this still left the lower back which became progressively more painful. Life was tough and I often used to wake in the night, sitting on the edge of the bed trying to ease the pain and find a comfortable position.

Come the morning I could hardly move and had to roll out of bed. The pain also started affecting how I walked. I had to keep stopping to find a wall to lean against because this gave me a moment of respite. Or I'd look for a bench and wedge my back against it because this eased the pain just a little.

I went ahead with treatment with injections. Since having these, I have been 100% pain free. I couldn't believe it at first and was tentative because I thought that at least some pain would return. It didn't and now after four weeks I can sail, garden and walk freely.