Case Profile: Disc Herniation with Right Nerve Root Irritation

Author: Fred Kahn MD, FRCS (C)
Source: Meditech International Inc.


Disc Herniation with Right Nerve Root Irritation


The patient is a 21 year old pro golfer who injured his cervical spine performing exercises. This resulted in radiation of pain to the right scapular area, shoulder and the lateral aspect of the arm. In addition, there was numbness and tingling in the extremity. The patient suffered from constant severe pain, had difficulty sleeping and was unable to engage in any meaningful physical activities for several weeks.

The MRI revealed a right paracentral disc herniation at the C5-6 level and a 4 mm right perineural cyst at the C4-5 level. Prior to Laser Therapy the pain had continued to increase in severity and necessitated taking 6 or more Tylenol tablets each day.

Physical Examination:

A moderate degree of tenderness was noted from C3-T1. The range of motion of the cervical spine with regard to flexion, extension, lateral rotation and lateral flexion was less than 10% of normal. Paracervical muscle spasm was pronounced. There was no evidence of gross motor impairment and no sensory deficit, however reflexes on the right were hypoactive.

Treatment Program:

Laser Therapy was applied initially for 5 consecutive days and subsequently every 2-3 days over the succeeding 3 weeks, for a total of 13 treatments.


After 5 treatments, subjective improvement achieved was in excess of 80%. Range of motion of the cervical spine had increased to 50% of normal range and paracervical muscle spasm was minimal. After 13 treatments the patient was asymptomatic. Range of motion of the cervical spine was within normal limits. No tenderness was noted and the utilization of analgesics had been completely discontinued. The patient was fully functional.

For maintenance therapy, weekly treatments were advised for several weeks with periodic reduction and phasing out therapy over the course of a year. This will be correlated with the patient’s activity levels as he continues his professional career in golf.

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