Cervical Radiculopathy
“Pinched nerve in neck”
Understanding Cervical Radiculopathy
Cervical radiculopathy refers to a condition where a nerve root in the cervical spine becomes compressed or irritated, leading to neurological symptoms in the areas served by that nerve. Commonly called a "pinched nerve," it results in pain, weakness, or numbness radiating from the neck to the shoulder, arm, or hand, depending on the affected nerve root. This condition can significantly impact a person's quality of life by limiting daily activities and causing persistent discomfort.
Causes and Symptoms Associated with Cervical Radiculopathy
One of the most common causes of cervical radiculopathy is age-related degeneration, including cervical spondylosis. This involves the gradual breakdown of intervertebral discs and the formation of bone spurs, which can compress nerve roots. Herniated discs are another frequent cause; when a disc ruptures or bulges, it can impinge on nearby nerves. Less commonly, traumatic injuries, infections, or tumors in the cervical spine may lead to nerve compression. In younger individuals, cervical radiculopathy is often due to sudden trauma or repetitive strain on the neck.
Symptoms vary based on the specific nerve root involved. Pain is often described as sharp or burning, radiating from the neck to the arm or hand. Numbness and tingling can occur in the affected regions, accompanied by muscle weakness. For example, compression of the C6 nerve root may cause pain and weakness in the biceps and wrist extensor muscles, while C7 involvement can lead to triceps paind and weakness that may extend into the top of the forearm and hand
Tests to Evaluate Cervical Radiculopathy
Diagnosing cervical radiculopathy begins with a thorough medical history and physical examination. Physicians often check for signs of muscle weakness, reflex changes, and sensory deficits. Special tests, like the Spurling’s maneuver, may be used to reproduce symptoms and identify the affected nerve root. Imaging studies, including X-rays, MRI, or CT scans, provide detailed views of the cervical spine, helping to pinpoint the cause of nerve compression. Electromyography (EMG) and nerve conduction studies may also be employed to evaluate the electrical activity of the affected nerves and confirm the diagnosis. Occasionally, selective nerve root injections (SNI) may be used to confirm involvement of a certain nerve root as a pain generator for the patient.
Non-Surgical Treatment of Cervical Radiculopathy
Treatment for cervical radiculopathy ranges from conservative to surgical, depending on the severity and duration of symptoms. Most cases respond well to non-surgical approaches, including physical therapy, which focuses on exercises to improve neck strength and flexibility. Nonsteroidal anti-inflammatory drugs (NSAIDs) and oral corticosteroids can reduce inflammation and pain. Epidural steroid injections may be recommended for more persistent symptoms, delivering medication directly to the inflamed area.
Surgical Treatment for Cervical Radiculopathy
Surgery is considered when conservative treatments fail or if there is significant neurological impairment, such as severe muscle weakness or progressive symptoms. Common surgical procedures include anterior cervical discectomy and fusion (ACDF), which removes the herniated disc or bone spurs and stabilizes the spine, or a cervical foraminotomy, which enlarges the nerve passageway to relieve pressure from the back of the neck without a fusion. Sometimes your surgeon may recommend cervical disc arthroplasty (CDA), which removes the herniated disc and replaces it with a disc replacement implant and avoid fusion.
