This condition is an irritation or compression of one or more nerve roots in the cervical spine. Because these nerves travel to the shoulders, arms, and hands, an injury in the cervical spine can cause symptoms in these areas. Cervical radiculopathy may result from a variety of problems with the bones and tissues of the cervical spinal column.
Cervical radiculopathy refers to neck pain that radiates into the shoulder and arm as a result of dysfunction of the nerve root in the neck, or cervical region of the spine. Sometimes known as a "pinched nerve," cervical radiculopathy can be caused by a herniated disk, bone spur, injury to the spine or osteoarthritis. When a nerve becomes irritated, it may send pain signals throughout the area through which it extends. Those considered at the highest risk for this condition are older individuals and younger people who play contact sports or perform manual labor.
Causes of Cervical Radiculopathy
Cervical radiculopathy often results from pressure placed on spinal nerves by either a herniated disc or bone spur. Herniated discs occur when too much force is exerted on an otherwise healthy intervertebral disc, while bone spurs develop when cartilage deteriorates and bones begin rubbing against each other. Bone spurs may cause a narrowing of the spinal canal, which can place pressure on a nearby nerve.
Additional causes of the condition include:
- Age, especially for those over the age of 50
- Degenerative diseases such as arthritis
- Conditions that cause changes in bones, including osteoporosis
- Traumatic injury
Symptoms of Cervical Radiculopathy
Cervical radiculopathy can result in pain near the injured nerve root of the cervical spine, which may radiate down one or both arms. Certain movements, such as extending the neck or turning the head, pull on the affected area and may worsen the pain. Additional symptoms of cervical radiculopathy may include:
- Muscle weakness in the arm, neck, chest, upper back or shoulders
- Tingling sensations down to the hands
- A lack of coordination, especially in the hands
Diagnosis of Cervical Radiculopathy
In order to diagnose cervical radiculopathy, a complete medical history is taken and a physical examination is conducted. The exam will typically include an evaluation of the patient's strength, reflexes and sensation of feeling. All of this information will provide the doctor with a better idea of what is causing the patient's neck pain.
To ensure the most accurate diagnosis, several diagnostic tests may be performed as well. These tests may include X-rays to view spinal alignment and discs, a CT scan to obtain detailed views of the spinal bones and electromyelography, which helps the physician study the electrical activity along the nerve.
MRI scans are the most commonly performed tests used to evaluate spinal conditions, since they offer clear visualization of the abnormal areas of soft tissue around the spine. In many cases, MRI scans are the only test needed to determine the cause of the neck pain. Unlike other imaging tests, MRI scans use magnetic fields and radio waves to view the structures of the neck. MRI scans also enable doctors to thoroughly examine the nerves and discs without using any dyes or needles.
Treatment of Cervical Radiculopathy
Cervical radiculopathy is generally treated with conservative measures first. Treatment plans may include a combination of pain medications including anti-inflammatory drugs and oral corticosteroids, which can help reduce pain and swelling. Steroid injections in the spine can be very effective for decreasing swelling, allowing for healing to take place. In severe cases, stronger prescription pain medications may be necessary.
Physical therapy can help strengthen the muscles in the problem area, maximize flexibility with stretching exercises and take some pressure off of the injured nerve roots. Cervical radiculopathy patients may also need to wear a soft collar around the neck. This will limit the range of motion in the neck and rest the muscles.
If conservative measures fail to provide a patient with relief or symptoms are worsening, surgery will often be required. There are several types of procedures that can be used to correct cervical radiculopathy. Anterior cervical discectomy and fusion (ACDF) is the most common surgery to treat cervical radiculopathy, since it restores the alignment of the spine and reduces the compression on the nerves. Posterior cervical laminoforaminotomy is another procedure used to alleviate symptoms of the condition by removing portions of the spinal bones that are compressing the nerve roots. Artificial disc replacement (ADR) is performed to remove the worn disc, relieve pressure on the nerves and restore height between the vertebrae.