Cervical Radiculopathy

What Is Cervical Radiculopathy?

Cervical radiculopathy, often called a pinched nerve, is the damage or a change in the way a nerve works resulting from one of the nerve roots near the cervical vertebrae being compressed. These seven small vertebrae form your cervical spine, or neck, and begin at the base of your skull. This the area in which cervical radiculopathy occurs.

The nerves that run through your cervical spine send messages back forth between your muscles and your brain. The roots of these nerves branch out through openings in your vertebrae called foramen. Damage to these nerve roots can cause pain and the loss of sensation along the nerve's pathway into the arm and hand, depending on where the damaged roots are located.

Cervical Radiculopathy Causes and Risk Factors

Damage can occur as a result of pressure from material from a ruptured disc, degenerative changes in bones, arthritis, or other injuries that put pressure on the nerve roots.

Common causes

Common causes of cervical radiculopathy include:

• Degenerative changes: In middle-aged people, normal degenerative changes in the discs can cause pressure on nerve roots. Cervical foraminal stenosis, for example, happens when these changes narrow the openings in your vertebrae, which causes them to pinch nerve roots
• Injury: In younger people, cervical radiculopathy tends to be the result of a ruptured disc, perhaps as a result of trauma. Disks often herniate with activity, such as when you bend, lift, twist, or pull. When you herniate a disk, its material then compresses or inflames the nerve root, causing pain.

Other causes

Less often, cervical radiculopathy is caused by:

• Infections in the spine
• Tumors in the spine caused by cancer
• Benign, or noncancerous, growths in the spine
• Sarcoidosis, the growth of inflammatory cells

Risk factors

Some factors can raise your risk for cervical radiculopathy. Your risk may be higher if you:

• Are white
• Smoke cigarettes
• Had a prior radiculopathy
• Lift heavy items
• Often dive into a pool from a diving board
• Drive equipment that vibrates
• Play golf

Cervical Radiculopathy Symptoms

The main symptom of cervical radiculopathy is pain that spreads into the arm, neck, chest, upper back and/or shoulders. Often, this affects just one side of your body.

A person with radiculopathy may also experience:

• Sensory issues, such as numbness or tingling in fingers or hands
• Motor problems, such as muscle weakness, lack of coordination, or the loss of reflexes in your arms or legs

Cervical Radiculopathy Diagnosis and Tests

To make a diagnosis of cervical radiculopathy, your doctor will first ask you to describe all your symptoms and review your medical history. They will also do a physical exam.

The exam will include a check of your neck, shoulders, arms, and hands for muscle weakness and problems with sensation or reflexes. Your doctor may ask you to move your arms or neck to see if certain movements cause or ease pain or other symptoms.

They may also do these tests:

• X-rays, to look for narrowing of vertebral openings or disk injury
• CT scans, to get more detailed pictures of your cervical spine
• MRI, to check for damage to nerve roots or soft tissues
• Electromyography, to see how your muscles work when they are at rest and contracted

Cervical Radiculopathy Treatments

For some people, the symptoms of cervical radiculopathy get better with time and don’t require treatment. If you do need treatment, your doctor will start with nonsurgical options.

Nonsurgical cervical radiculopathy treatments

Nonsurgical treatment for cervical radiculopathy usually involves medications, physical therapy, or a combination of these.

• Medications: These may include corticosteroids (powerful anti-inflammatory drugs) or nonsteroidal pain medication like ibuprofen or naproxen. Steroids may be prescribed either orally or injected epidurally (into the space surrounding the dura, which is the membrane that surrounds the spinal cord).
• Physical therapy: This might include gentle cervical traction and mobilization, exercises, and other modalities to reduce pain.

Surgical cervical radiculopathy treatments

If significant compression on the nerve exists to the extent that motor weakness results, surgery may be necessary to relieve the pressure.

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