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While some degree of disk degeneration is inevitable, people can reduce their risk by practicing good posture (during sitting, standing, and lifting), performing neck-stretching exercises, maintaining an ideal weight, and quitting smoking.

For patients with cervical discogenic pain with or without radiculopathy, physical therapy should be focused on educating the patient about proper posture, proper body mechanics, and how to implement a specific exercise program. The exercise program should be supervised initially to assure proper technique and performance of the exercises.

The McKenzie method of mechanical evaluation and treatment of the cervical spine involves establishing a baseline ROM with single cervical spine motion in each direction, a baseline level of pain, and a baseline of more distal or peripheral symptoms, as well as identifying patterns of movements or positions that decrease symptoms and improve the segmental motion. At times, it is necessary to add force by a mobilization or manipulation to attain end range of movement in the already identified direction of preference.

After obtaining a baseline of ROM and symptoms, test repetitive motion of the cervical spine to the end range of each direction by frequently assessing the changes in the initial symptoms and ROM with repetitive end range movement. If symptoms worsen as a result of repetitive movements in a particular direction, that particular movement should be stopped immediately.

If symptoms and/or ROM improve upon a specific direction of motion (ie, retraction) and no symptoms peripheralize, a direction of preference is established. This direction of preference is used in a specific rehabilitative exercise program.

At times, patients with radicular symptoms can experience the phenomenon of centralization. McKenzie described centralization as the phenomenon whereby as a result of the performance of certain repeated movements or the adoption of certain positions, radiating symptoms originating from the spine and referred distally are caused to move proximally toward the midline of the spine.Centralization is the hallmark sign that a correct movement or position is being performed, whereas peripheralization is a contraindication to further movements in that direction.

Cervical Degenerative Disc is a normal part of the aging process which makes its mark on most individuals by the age of 30 or so. Some people are far more susceptable to developing early CDDD and some are more prone to developing problematic CDDD. This diagnosis is virtually never the actual reason for severe or chronic back pain, although it is commonly made as an exclusive problematic condition. If you have had your chronic disc pain blamed on CDDD, you owe it to yourself to learn the facts about the condition and why it is not typically responsible for pain in the vast majority of patients. Most individuals with any form of diagnosed degenerative disc disease respond very well to knowledge therapy, since this treatment is especially effective at dispelling the myths and fears associated with DDD. For the very few patients who are experiencing actual ongoing pain from an abnormal and advanced case of disc degeneration, spinal decompression demonstrates good curative results. This treatment gets my recommendation over any form of disc surgery virtually every time.

If the spine is in overall good position, spinal implants may not be necessary. So while not all spinal fusions require implants, many patients whose spines are weakened by injury or disease or whose deformities must be corrected are treated with internal fixation or spinal implants. If the spine needs to be placed and maintained in a new position, spinal implants will typically be necessary. The implants can include rods, screws, and hooks to fixate and stabilize the spine. Various types of implants are used depending on the problem that required the fusion, the patient’s age, and the surgeon’s judgment. These implants are usually left implanted indefinitely to minimize the possible loss of spinal alignment. The development of a spine fusion may take up to one year during which time physical activity may be limited and a spine brace may be recommended.

Fusion surgery is inherently more complicated, more painful, and riskier than procedures such as discectomy and laminectomy. There is no consensus in the medical community as to the appropriate indications for fusion surgery.