Cervical Radiculopathy

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Overview

Cervical radiculopathy occurs when a nerve in the neck (cervical spine) becomes compressed or irritated. These nerves exit the spinal cord and travel into the shoulders, arms, and hands.

When a nerve is affected, it can cause pain, numbness, or weakness along the path of that nerve. Cervical radiculopathy is often referred to as a pinched nerve in the neck.

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Symptoms

Symptoms depend on which nerve is affected but may include:

  1. Neck pain
  2. Pain that radiates into the shoulder, arm, or hand
  3. Numbness or tingling in the arm or fingers
  4. Muscle weakness in the arm or hand
  5. Burning or sharp pain with certain neck movements

Common patterns include:

  1. C5 nerve: Shoulder and upper arm pain
  2. C6 nerve: Pain and weakness in the biceps, wrist, thumb, and index finger
  3. C7 nerve: Pain and weakness in the triceps and middle finger
  4. C8 nerve: Weak grip and pain in the ring and little fingers

Causes

Cervical radiculopathy is usually caused by conditions that put pressure on a nerve in the neck.

Common causes include:

  1. Herniated disc in the cervical spine
  2. Bone spurs (osteophytes)
  3. Cervical spondylosis (age-related degeneration)
  4. Narrowing of the spaces where nerves exit the spine (foraminal stenosis)

Risk factors include:

  1. Smoking
  2. Heavy lifting
  3. Repetitive neck movements
  4. Operating vibrating machinery
  5. Neck injuries or trauma

Diagnosis

Diagnosis begins with a medical history and physical examination. A doctor will evaluate pain patterns, strength, sensation, and reflexes to identify the affected nerve.

Imaging tests may include:

  1. MRI scans to detect nerve compression and soft tissue problems
  2. CT scans for detailed images of the spine
  3. CT myelograms to assess nerve root compression

These tests help confirm the diagnosis and locate the affected nerve.

Treatment Options

Most cases improve with non-surgical treatment.

Common treatment options include:

  1. Short-term use of a soft cervical collar to limit movement
  2. Physical therapy to improve strength, flexibility, and posture
  3. Activity modification to reduce strain on the neck

Additional treatments may include:

  1. Cervical traction to relieve pressure on nerves
  2. Cervical epidural steroid injections to reduce inflammation

Surgery may be considered if symptoms worsen, do not improve with treatment, or if there is significant nerve damage or spinal cord compression.

Frequently Asked Questions

It’s often called a “pinched nerve in the neck” — a nerve exiting the cervical spine becomes compressed or irritated, causing pain, numbness, or weakness that travels into the shoulder, arm, or hand.

Symptoms depend on which nerve is affected, but commonly include neck pain, pain radiating into the arm, numbness or tingling in the fingers, and weakness — for example, the C6 nerve tends to affect the biceps, wrist, and thumb, while C7 affects the triceps and middle finger.

It’s usually caused by something putting pressure on a nerve in the neck, most often a herniated disc, though other structural changes in the cervical spine can also compress a nerve root.

Not exactly — a herniated disc is one common cause of cervical radiculopathy, but radiculopathy refers to the nerve symptoms themselves, which can also result from bone spurs or other changes narrowing the space around the nerve.

Many cases improve with conservative treatment like physical therapy, activity modification, and anti-inflammatory medication; nerve blocks or other interventions may help if symptoms persist.