Cervical radiculopathy, also known as “pinched nerve,” is a condition that occurs when a cervical nerve root in the neck is compressed, pinched, or irritated by a herniated disc, disk degeneration, or arthritic bone spur. This impingement typically produces neck and radiating arm pain, numbness, sensory deficits, or motor dysfunction in the neck and upper extremities.
Causes of Cervical Radiculopathy
There are various causes of cervical radiculopathy, which include the following:
Age-related problems may lead to cervical radiculopathy, including:
- As you age, many degenerative changes may occur, which affect the spine, a condition known as spondylosis.
- You may also develop arthritis, which involves inflammation of the joints.
- Weakening the disks which sit between the seven vertebrae in the cervical spine may cause stiffness, dryness, or displacement of the disks putting pressure on the nerves.
- Cervical foraminal stenosis may also occur as a person ages when holes in the bone become too narrow and pressure the nerves. This is a common cause of cervical radiculopathy.
Injury or Trauma
Cervical radiculopathy may happen due to neck injuries and a slipped disk when one of the cushioning disks between the vertebrae has moved out of place. A herniated disk can result from a single injury or be caused by repetitive heavy lifting, pulling, bending, or twisting motions. Fractures in the cervical spine may also cause cervical radiculopathy.
Tumor or Cancer
Cancer or a tumor may grow in a place that puts pressure on the cervical root nerve and cause cervical radiculopathy.
A cervical spine infection may cause inflammation or damage to the cervical nerve root leading to cervical radiculopathy.
Sarcoidosis is a condition that leads to swollen tissue and may appear in the cervical spine resulting in a pinched nerve.
Other autoimmune conditions like psoriatic arthritis, rheumatoid arthritis, or lupus can also lead to this condition.
The risk factors for getting cervical radiculopathy include the following:
- Heavy manual labor that requires constant lifting of heavy items
- Advancing age
- Driving equipment that vibrates
- Contact sports
- Strenuous shoulder activities
- Neck trauma
- Often diving into a pool from a diving board
- Had a prior radiculopathy
- Playing golf
- Smoking cigarettes
Symptoms of Cervical Radiculopathy
The most common symptom of cervical radiculopathy is pain that starts at the neck and spreads down into the arm, neck, chest, upper back, or shoulders in the area served by the damaged nerve. This pain can be described as burning or sharp. Some neck movements, such as extending or straining the neck or turning the head, may increase the pain. Other symptoms may include:
- Tingling or a feeling of “pins and needles”
- Muscle weakness
- Loss of reflex in your arms or legs
- Weakened reflexes
- Lack of coordination
Cervical Radiculopathy Diagnosis
To diagnose cervical radiculopathy, your doctor will take down your complete history about everything you can remember relating to your neck pain. Your doctor might also ask you the following questions:
- When did the pain start?
- What causes your neck pain?
- Have you increased your physical activity level?
- Have you had an injury or surgery to your neck at any given time?
- Does the pain travel down into your arms and legs?
- Do you have any problems with your bowel or bladder?
Once you have given your medical history, your doctor will conduct a thorough physical exam to determine how well your neck is functioning. Your doctor might examine the following:
- How well you can bend and roll your neck in all directions
- Check on tenderness around the neck
- Check whether there are muscle spasms around the neck and shoulders
Other clinical tests to examine the nerves will be done, and they may include:
- Test for numbness in the arms and hands
- Test for nerve irritation signs
- Check the reflexes
- Test the strength of the muscles in the hands, arms, and legs.
The most common diagnostic methods used to assess the presence of possible compression are:
Spine X-rays: X-rays can show problems that affect the bones, such as fractures, tumors, or infections. They will show how much degeneration and arthritis are affecting the neck. Different views or angles can reveal different issues, such as narrowing the disc space between each vertebra and foraminal narrowing (stenosis).
Magnetic resonance imaging (MRI): Unlike other tests, MRI, which uses magnetic fields and radio waves, can show pictures of your nerves and discs without using special dyes or needles. Pictures can also be taken in a cross-section view.
Computed tomography (CT) scan: This uses X-rays and computers to produce and show images of structures inside your body. A spiral CT is the best way to detect foraminal stenosis, which causes a bony compression on the nerve.
Electromyography (EMG): This test measures muscle response or electrical activity in response to nerve stimulation of the muscle. It will determine if the nerve is functioning normally
Treatment For Cervical Radiculopathy
In most cases, patients with cervical radiculopathy get better over time and do not need any specific treatment. It is common for cervical radiculopathy to return in the future after it had improved. In some cases, it does not improve, and these patients require evaluation and treatment. The two main goals of cervical radiculopathy treatment include:
- Pain relief
- To reduce any risk of re-injury
Your doctor will personalize treatment plans based on the severity and underlying cause of your cervical radiculopathy. Treatment plans may include the following:
Nonsteroidal anti-inflammatory drugs (NSAIDs) medications such as aspirin, ibuprofen, and naproxen offer sufficient relief and help to reduce pain and inflammation associated with nerve damage. Your doctor may also prescribe a short course of oral corticosteroids to alleviate swelling and inflammation. Steroids injection may lessen the swelling and relieve the pain long enough to allow the nerve to recover. In cases where the patient is in severe pain, doctors may prescribe narcotics that are much stronger than NSAIDs and corticosteroids for a limited period.
This may include an exercise program (tailored for you), gentle cervical traction, and mobilization to reduce pain.
Soft Cervical Collar
This padded ring wraps around the neck and is held in place with Velcro. Your doctor may recommend wearing a cervical collar so your neck muscles can rest and limit neck motion. It should be worn for a short period.
These are specially designed pillows used to place the right amount of curvature in the neck while you sleep and decrease the amount of irritation on the nerve roots.
Epidural steroid Injection (Nerve Block)
If other treatments do not relieve your back pain, you may be given an epidural steroid injection or a cervical nerve block. This injection may control the inflammation surrounding the nerves.
In severe cases, surgery may be recommended to treat underlying conditions related to cervical radiculopathy. The types of surgery that doctors may recommend include:
Anterior cervical discectomy and fusion: The surgeon removes the disc that causes problems.
Artificial disc replacement: This involves removing the problematic disc and replacing it with an artificial one.
Posterior cervical laminoforaminotomy: The surgeon makes an incision in the back of the neck with this procedure. They then scrape down the back of the spinal canal and remove any problematic bone spurs, discs, or tissues.
After surgery, you may be able to go back to work within a few days or weeks and return to full activity in 3 to 4 months, depending on the surgery you had.
For more information, don’t hesitate to contact American Neurospine Institute, PLLC, today or schedule an appointment online.