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Cervical radiculopathy

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What is cervical radiculopathy?

Cervical radiculopathy is the term used to describe a pinched nerve in your neck region (cervical spine), which affects the nerves that travel to your arms, shoulder and hands. It happens when the surrounding muscles, cartilage, bones or tendons are damaged or have some level of degeneration.

You have seven cervical vertebrae in your neck, with a disc of cartilage between each. These vertebrae protect your spinal column and provide stability and rotation for your head. Eight nerve roots originate in this part of your spinal column and exit through a space called the intervertebral foramen. Damage to these nerves can result in inflammation that causes pain, numbness and lack of function in your arms, neck, shoulder and hands.

Cervical spine. 

Causes

There is a wide range of causes of cervical radiculopathy;

Disc herniation

Otherwise known as disc prolapse or a 'slipped disc', this happens when you damage one of the intervertebral discs that cushion your spinal vertebrae. Your discs are fibrous capsules filled with a gel-like substance. As you age, these discs can bulge, stiffen, lose volume and become more susceptible to injury. If damaged, the gel-like substance can leak out from the discs and put pressure on your spinal nerves. Disc prolapse is a commonly-seen feature in arthritis.

Bone spur

If your intervertebral discs are damaged, collapse or become worn, they lose height and volume and the ability to provide cushioning. Your body responds by building extra bone around the disc to strengthen it. These new areas of bone are called bone spurs. They can pinch your spinal nerves by narrowing the space where they emerge (stenosis) and cause stiffening of your spine. They are a common cause of cervical radiculopathy, especially in older people.

Spinal stenosis

Spinal stenosis occurs when the spinal column becomes narrower, compressing the spinal cord and/or spinal nerves. It can be due to damaged discs or ligaments, bone pressing on your nerve, or Paget's disease, which is a rare bone condition.

Trauma

Injury to your cervical spine can be caused by blunt trauma or a heavy impact to your head. Your intervertebral discs are designed to take the force of impact, but can easily burst or rupture if this force is too strong, if they have begun to degenerate, or have been injured before. Your ligaments and muscles can also sustain damage during an accident, creating localized pain and inflammation.

Other causes

There are a wide range of other causes of cervical radiculopathy, including the following:

Risk factors

There are a number of risk factors for cervical radiculopathy to be aware of. They include:

  • Previous injury to your neck or spine;
  • Arthritis;
  • Repetitive movements and carrying heavy weights, and;
  • Poor posture and obesity.

Signs and symptoms

The range of symptoms you experience may differ, depending on which nerve root is being pinched and the cause of it. Many cases of cervical radiculopathy do not cause any pain - just weakness, pins and needles or numbness in the affected limb. However, symptoms include the following:

Methods for diagnosis

Medical history

Your doctor will take a full medical history to note any injuries, accidents, work or sports-related muscle pain you have experienced. It is helpful to mention all your symptoms, with details such as when the pain or numbness started, what caused it, what makes it better or worse, what activities trigger it and any other relevant information you can think of.

Physical examination

You may be asked to perform a number of gentle neck, hand and arm movements to assess your mobility. Areas of numbness and weak muscles will be noted to help build a diagnostic picture.

X-rays

Spinal X-rays will detect any bones that are sitting out of place, fractures and bone spurs.

Electromyography (EMG) and nerve conduction study

This procedure uses small electric shocks to assess muscle and nerve function. The study can detect the presence and location of nerve injury.

Computerized tomography

A computerized tomography (CT) scan can detect any bony causes of cervical radiculopathy.

Magnetic resonance imaging

Magnetic resonance imaging can be used to identify tissue damage and spinal stenosis.

Blood tests

You may be asked to provide a blood sample to rule out the following underlying conditions:

Types of treatment

The type of treatment depends on the cause of cervical radiculopathy:

Medications

Physiotherapy

A physiotherapist is an expert in how your muscles work and, in particular, how to rehabilitate them after an injury or sprain. They can assess the condition of your muscles, tendons and ligaments, then design exercise programs to strengthen them. Your physiotherapist can teach you exercises and stretching techniques that you can then use at home.

Soft collars

You may be given a soft collar to wear for a few weeks - this will rest your neck muscles and, as they reduce movement, will also reduce nerve pinching. Long-term use of a collar is not beneficial and might make your condition worse.

Surgery

Surgery to relieve nerve compression will be considered if other treatments are not successful. All forms of surgery carry risks - these can be discussed with your surgeon before a decision is made:

Home care

Traction

This involves using a specially-designed treatment couch, which allows gentle stretching to relieve compression on your spinal column.

Manipulative therapies

Chiropractic and osteopathic manipulation techniques may help relieve symptoms associated with spinal compression. Deep tissue massage can also help by relaxing tense muscles and stopping muscle spasms. Applying a heat pack beforehand encourages muscular relaxation.

Acupuncture

Acupuncture and dry needling may help relieve neck pain, by targeting tense muscle groups and aiding relaxation.

Potential complications

Complications from surgery for cervical radiculopathy can include infection, anesthetic risk, paralysis and damage to local nerves and tissues.

Prognosis

The outlook for most cases of cervical radiculopathy is good. Using self-care measures, medications and keeping as physically healthy as possible will help keep symptoms at bay. Physiotherapy will help keep your spine flexible.

Prevention

Some instances of cervical radiculopathy cannot be prevented, but avoiding activities that may damage your neck is advisable. Maintaining good posture and avoiding activities that trigger your symptoms can help.

10 Most frequently asked questions (FAQs)

What is cervical radiculopathy?
Cervical radiculopathy is the term used to describe a pinched nerve in your neck region (cervical spine) that affects the nerves that travel to your arms, shoulders and hands. The nerve root gets compressed and this often leads to inflammation, with shooting pain radiating down your arm. However, sometimes no pain is felt - just pins and needles, weakness and numbness in the limb.
What are the symptoms of cervical radiculopathy?
Symptoms of cervical radiculopathy can include: tingling and weakness in your arm, neck, shoulder and upper back; sharp nerve pain that radiates down your arm or to your fingers; pain and stiffness in your neck; pain that originates in your neck when you make certain head movements, and; tingling and weakness in your fingers or thumbs.
What causes cervical radiculopathy?
One of the most common causes of cervical radiculopathy is disc herniation. This puts pressure on the spinal nerve root, causing inflammation, pain, weakness or numbness. Other causes can be tumors, obesity, trauma, arthritis, poor posture, repetitive actions or sports, pregnancy and infections such as herpes zoster and Lyme disease.
How is cervical radiculopathy diagnosed?
to diagnose cervical radiculopathy, your doctor will examine you, take a full medical history then perform a physical examination to check if you have nerve compression. You may also be sent for X-rays, MRI or CT scans, or an electrical nerve conduction test with an electromyography (EMG), to test how your nerve pathways are working.
What increases the chances of developing cervical radiculopathy?
There are several risk factors for cervical radiculopathy to be aware of: previous injury to your neck or spine; arthritis; obesity; repetitive movements and carrying heavy weights, and; poor posture.
How is cervical radiculopathy treated?
Cervical radiculopathy is treated with medications such as ibuprofen, oral corticosteroids and steroid injections. Physiotherapy and heat packs or ice packs can all be useful. Surgery is only considered if all else fails.
Will cervical radiculopathy clear on its own?
Some cases of cervical radiculopathy will resolve within a few weeks with treatment. Other cases, in particular those caused by degenerative changes in your intervertebral discs, may need ongoing management.
What can be done at home to treat cervical radiculopathy?
Home care for cervical radiculopathy can include ice packs or heat packs to provide immediate relief from some types of pain - experiment to see which works for you. Ice packs should not be placed directly on your skin, as they may cause nerve damage; Wrap them in a towel. Avoid triggers: if you have an injury or inflammation due to overuse. The best remedy is to avoid that action until you have healed. Get a good pillow. Stretching exercises, gently rotating your head and side tilts will encourage blood flow and relax tired muscles.
Can cervical radiculopathy be prevented?
Most cases of cervical radiculopathy cannot be prevented, but you can try to avoid situations that may cause damage to your neck. Use safety gear if doing sports where you may suffer a blunt impact. Invest in a good pillow and avoid activities that can strain your neck.
What is the outlook for cervical radiculopathy?
The outlook for most cases of cervical radiculopathy is good. Using self-care techniques, medications and keeping as physically healthy as possible will help keep symptoms at bay. Physical therapies such as stretching will help keep your spine flexible.

Related topics

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Spinal injury can occur to the bones (vertebrae) that make up the spine, or to the spinal cord, which is the bundle of nerves running down the neck and spine that carries electrical signals between the brain and body. Spinal cord injury can disrupt these signals and is therefore extremely serious, because it can result in loss of movement (paralysis) below the point of injury. Damage to the verteb

Carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is a condition that causes pain, numbness and tingling in the fingers and hands. It is caused by compression of the median nerve in the wrist. The condition can be made worse by certain physical activities.

Polymyalgia rheumatica (PMR)

Polymyalgia rheumatica, or PMR, is inflammation of the shoulders and hips that causes pain and stiffness, often after sleep or rest. It is most often found in people over 50 years of age. PMR can be treated with low doses of corticosteroid medication.

Spinal stenosis

Spinal stenosis is an abnormal narrowing of the spinal canal that can cause varying symptoms, depending on the location and severity of the narrowing. Symptoms may include numbness, weakness or pain in the limbs, as well as bladder, bowel or sexual dysfunction. Treatment can include physical therapy, medication and surgery.

About this article

Title: Cervical radiculopathy

Author: Dr Idan Ben-Barak PhD, MSc, BSc (Med)

First Published: 15 Jul 2015

Last reviewed: 17 Jan 2022

Category: Information on Cervical radiculopathy

Average rating: 4.7 out of 5 (1557 votes)

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