The spinal column protects the spinal cord and nerve roots, as well as offering some level of protection to many internal organs. The spine acts as a point of attachment for ligaments, tendons and muscle. It provides structural support and aids in balance and weight distribution and provides mobility and flexibility. When a vertebral disc becomes herniated or ruptured, it can cause intense pain and greatly restrict mobility.
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The Spinal Column
The spinal or vertebral column consists of 33 vertebral bones, and extends from the skull to the pelvis. The bones are stacked on top of one another, and categorised in four sections plus the coccyx (tailbone) which has three vertebrae. The Cervical section is the neck area, and consists of seven vertebrae labelled C1 to C7. The Thoracic region consists of twelve vertebrae and encompasses the chest area, these vertebrae are abbreviated as T1 to T12. The lumbar region is the lower back region and generally consists of six vertebrae, categorised as L1 to L5. The Sacrum is the pelvis region, consisting of five vertebrae labelled as S1 to S5. Between each of the vertebra sits a soft rubbery disc. These discs act as shock absorbers and allow the back to bend and flex.
The C2 vertebra is also known as the axis and is the second cervical vertebra. The specific shape of the C2, when combined with the C1, allows for rotation of the head and neck.
Cervical Herniated Disc
A herniated or ruptured disc in the cervical region is the second most common type of back injury, with the lumbar region being the most common. If the discs suffer a significant trauma, it may cause one of these discs to rupture or become herniated, which means that the disc is not positioned correctly.
Spontaneous ruptures can cause severe short term pain, resolving itself in six to eight weeks. Moderate to severe pain can occur when the position of the ruptured disc applies pressure on the nerve roots or spinal cord. Pain or a sensation of numbness can be present in the area of the body affected. A C2 rupture will most likely cause pain in the neck and shoulders, and may also restrict movement in the shoulder, neck and arms. If the rupture is not applying pressure to a nerve, there may be no symptoms at all. A sensation of weakness may be present in the area affected by the nerve which the rupture is applying pressure to, as well as localised and persistent tingling.
In most cases, the rupture will heal by itself within one to six months, with pain disappearing within six to eight weeks. Treatment often involves pain relieving and anti-inflammatory medication. It also often involves educating the patient valuable back care techniques to prevent a worsening or future recurrence of the rupture. Techniques such as correct moving and handling and lifting techniques are often taught. A period of rest is usually advised, with the patient being told to gradually increase levels of physical activity over a period of weeks. A physiotherapist may be asked to teach exercises to reduce pain and strengthen back muscles.
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