What is cervical radiculopathy?
Pain in the neck that radiates to the shoulder and often down the entire arm is often caused by a pinched nerve in the neck. This is known medically as a cervical radiculopathy. The spine is comprised of a column of bones called vertebrae and within the vertebra lays the spinal cord. In the neck or cervical spine, nerves leave the spinal cord through openings in the vertebra and run down the arm providing sensation and motor function to the arms. Pressure on the nerves as they exit the vertebra can be caused by a variety of things such as a herniated disc or arthritis in the neck. Pressure on the nerves can lead to pain, weakness and loss of sensation in the arm. Sometimes, even though the problem is in the neck there is no neck pain associated with a cervical radiculopathy.
Who gets cervical radiculopathy?
Anyone can get
a cervical radiculopathy. As we age the discs between our vertebra lose water content and become narrowed. The bones in the spine then move closer together leading to bone spurs that can pinch a nerve. Disc injuries can also happen from an injury such as lifting something heavy. Even minor injuries can sometimes injure a disc. Poor lifting techniques can cause injury even if the load isn’t heavy. It is important to note that even though as we age degenerative changes occur in the neck, it does not usually lead to a cervical radiculopathy.
How is the diagnosis for cervical radiculopathy made?
Many patients come to or are referred to a hand specialist since the pain is mostly in the arm. A careful history and examination by the doctor will usually help make the diagnosis. Weakness and/or wasting of muscles supplied by a particular nerve may be found. Low reflexes in the arm may also result from pressure on certain specific nerves in the neck. Numbness in particular distributions helps with making a correct diagnosis. An x-ray can show if there is any arthritis in the neck but is not helpful to see if there are any pinched nerves. An MRI is the best test to evaluate the nerves in the neck. Sometimes nerve conduction studies are ordered to help evaluate the nerves in the arm. In rare cases it is associated with bowel and bladder problems and severe weakness in the arms and legs and in these cases immediate medical attention is required.
How is cervical radiculopathy treated?
Usually the condition improves on its own in 6 to 8 weeks regardless of treatment. In the early stages rest, anti-inflammatory medication and physical therapy can be helpful in improving symptoms. While most people recover, others may need more invasive treatments such as a steroid injection or even surgery to remove the pressure on the nerve. A consultation with a spine specialist at this point would be needed. At the Brooklyn Orthopedic Institute, spine specialists, pain management doctors and therapists work together to provide you with comprehensive care of your condition.