Cervical Radiculopathy

 

Usually, when something hurts, you do not have to look far to find the source of the pain. But an injury near the root of a nerve can result in pain at the end of the nerve where sensation is felt. For example, an injury to the vertebrae or disks in your neck (cervical vertebrae) can result in pain, numbness, or weakness in your shoulder, arm, wrist, or hand because the nerves that extend out from between the cervical vertebrae provide sensation and trigger movement in these areas. This condition is called cervical radiculopathy.

Cause

Several conditions can put pressure on nerve roots in the neck. The most common causes for cervical radiculopathy are:

  • Herniated cervical disk – When the outer layer (annulus) of the disk cracks and the gel-like center (nucleus) breaks through, it causes the disk to protrude, putting pressure on the nerve that exits the spinal column at that point. The nerve may become irritated, swollen and inflamed when pinched by a herniated disk.
  • Spinal stenosis – This occurs when the space in the center of the vertebrae narrows and squeezes the spinal column and nerve roots.
  • Degenerative disk disease – The water content of body cells diminishes with age and other chemical changes occur that can cause the disks to shrink. Without sufficient cushioning, the vertebrae may begin to press against each other, pinching the nerve, or to form bony spurs.

 

Diagnosis

Your physician will give you a careful examination and ask about your symptom history. You may be asked to extend and rotate your neck and/or arm to reproduce the pain symptoms.

An X-ray will usually show any degenerative disk problems. Your physician may also request MRI (magnetic resonance imaging) or a CT (computed tomography) using a colored dye to outline the nerves.

Treatment

Initial treatment for cervical radiculopathy is usually conservative and aims to reduce the pain by easing the pressure on the nerves. The treatment consists of three parts: rest, medication, and physical therapy.

  • Limited Activities – You may be asked to rest for just a few days or wear a soft cervical collar to limit motion and relieve irritation on the nerves. It is important to return to normal activities as soon as possible.
  • Medication – Your doctor may prescribe a non-narcotic pain medicine and anti-inflammatory drugs to relieve any swelling.
  • Physical therapy – After muscle spasms subside, your orthopaedic surgeon may prescribe a cervical traction device or other types of physical therapy such as heat or cold therapies, electrical stimulation, or isometric and stretching exercises.

If conservative treatment fails to relieve your pain over the course of 6 to 12 weeks, surgery may be an option. The surgical procedure will depend on the underlying condition. Your orthopaedic surgeon will discuss the options with you. In most instances, surgery not only relieves the pain, but also improves functioning and movement of the affected areas.