Expert: Gerald Anzalone, D.C. - 11/20/2010

Question
Do you know exactly how and what/technique massage you should be using to cure a slipped disk/pinched nerve?, the following are my MRI results:

MRI:  
c5-6: degenerative disc signal 2mm posterior disc bulge extending greater to the left.  Mild neural foraminal narrowing on the left predominantly secondary to bulging intervertebral disc.

C6-7, C7-T1:  Mild straightening of the normal cervical lordosis.

Should you be using direct electromagnetic radiation on the part that's painfull?  Exactly where do you exactly place the pads?, is it possilble to purchase these Electro magnetic radiation pads, if so where?

Should you be sore around the bottom of your neck after initial massage/electro magnetic treatment of this?  I'm feeling a burning sensation on the bottom of my neck after all this sitting for a while on the computer.


Thanks in advance,  

Answer
Richie,

Thanks for your question.

The most notable finding in the MRI results you provided is the mild neural foraminal narrowing on the left C5-C6 segments. Effectively treating the symptoms of a disc herniation or disc bulge often requires a multi-faceted approach.

Depending upon the patient's response to a particular treatment modality, as well as the patient's preferences, usually the most effective approach to treating a cervical disc bulge or herniation involves some manual therapy (either a combination of massage/soft tissue therapy to address tight muscles or muscles in spasm, which are usually a response to the localized inflammation of a disc bulge or herniation), spinal manipulation or mobilization, rehabilitative exercise, and if necessary, pharmacological agents such as anti-inflammatory medication, muscle relaxers, or analgesics.

For a better understanding of how to perform appropriate rehabilitative exercises, I often recommend the book Treat Your Own Neck by the Australian physiotherapist Robin McKenzie.

The failure of the patient to respond to a dedicated course of conservative therapy, which may also include epidural corticosteroid spinal injections, usually performed in a pain management clinic, may require additional testing, often performed by a neurologist, such as EMG (electromyography) and NCV (nerve conduction velocity) to determine if there is a peripheral neuropathy resulting from the disc lesion.

Typically, surgical intervention is reserved for patients whose condition fails to respond to conservative measures, or which worsens, resulting in arm weakness, loss of function, or intractable pain.

The use of various forms of electrical muscle stimulation may be helpful as a temporary pain-reducing modality; however, because of the potential for an individual to misuse these modalities in a non-clinical setting, I do not recommend them for patients to use at  home; additionally, any negative sensations felt after using such modalities should be brought to the attention of the therapist or doctor who is supervising their use.

I hope that this helps to answer your question.