A cervical disc herniation occurs when a disc in the neck protrudes and presses on a nerve root or the spinal cord. It is most common at C5-C6 and C6-C7. The typical picture is pain spreading from the neck into the shoulder and arm, with numbness in the fingers.
Symptoms
- Pain from the neck to the shoulder blade, shoulder and down the arm
- Numbness and tingling in the fingers — which fingers tells you which nerve is involved
- Reduced grip or arm strength
- Difficulty turning the head to one side
- Arm pain that increases when you tip the head back or turn toward the affected side
- Arm pain that decreases when you rest your hand on top of your head (shoulder abduction sign) — this is specific to nerve root compression
Which finger points to which level
| Area affected | Nerve root | Weakened movement |
|---|---|---|
| Thumb and index finger | C6 | Wrist extension, elbow flexion |
| Middle finger | C7 | Straightening the elbow |
| Ring and little finger | C8 | Spreading the fingers, grip |
When it is urgent
These findings suggest spinal cord involvement and need prompt medical assessment:
- Clumsiness in both hands: trouble with buttons, dropping objects
- Unsteadiness when walking, a sense that the feet are not your own
- Change in bladder control
- Stiffness or weakness in the legs
Causes
- Prolonged forward head posture — phone and laptop use
- Sleeping on a high pillow or several pillows
- Sudden neck strain, whiplash in a vehicle collision
- Age-related loss of disc height
- Weakness of the shoulder girdle and deep neck muscles
The load on the neck rises substantially in a forward head position. Spending hours a day there is chronic loading added to a disc that is already wearing.
How physiotherapy is planned
Acute phase: settle the arm pain
The priority is drawing pain out of the arm and back toward the neck. Symptoms consolidating from the periphery toward the centre — centralisation — is the most reliable sign of a good outcome.
- Repeated neck movements in the direction that reduces pain
- Cervical traction, which relieves root compression in selected patients
- Arm positioning and sleep set-up: on your back, with a single thin pillow
- Hands-on release of upper trapezius and scalene muscles
Middle phase: restore movement and posture
- Deep neck flexor activation — chin tuck, low load and frequent repetition
- Scapular control: lower trapezius and serratus anterior work
- Thoracic spine mobility — the most effective region for offloading the neck
- Workstation set-up: top of the screen at eye level, elbows supported at 90 degrees
Late phase: prepare for load
- Shoulder girdle strengthening
- Graded return to overhead arm use
- Nerve gliding (neural mobilisation) exercises
- Embedding protective habits into the daily routine
Three exercises you can do at home
1. Chin tuck Sit tall. Draw your chin gently back, as if lengthening the back of your neck. Do not tip your head down. Hold five seconds, ten repetitions, five or six times a day.
2. Scapular squeeze Arms by your sides, draw the shoulder blades together and slightly down. Hold five seconds, ten repetitions.
3. Upper trapezius stretch Hold the edge of your chair with your right hand. Tip your head to the left until you feel a gentle stretch. 20–30 seconds, three times each side.
If any exercise increases your arm pain or spreads the numbness further down, stop and tell your physiotherapist.
Is surgery needed?
Most cervical herniations settle without it. Surgery is considered for:
- Signs of spinal cord compression
- Progressive muscle weakness
- Disabling arm pain persisting after 6–12 weeks of properly delivered conservative care
Frequently asked questions
What pillow should I use? A single pillow that fills the gap at your shoulder when side-lying and supports the natural curve when on your back. Two stacked pillows push the neck forward.
Is cracking my own neck harmful? Repeated forceful self-manipulation loosens the joint capsule and can lead to instability over time. The relief is brief and does not address the underlying restriction.
What should I do at a desk? Stand up every 30–40 minutes, do three chin tucks, open the shoulders back. Raising the screen is the single most effective change.
Can I exercise? During acute arm pain, overhead loading and neck-loaded exercise are postponed. Walking, cycling and lower-body work can usually continue.
This article is general information and does not replace an examination. For arm pain or numb fingers, book an appointment at our clinic in Muratpaşa, Antalya.