Cervical radiculopathy

Cervical radiculopathy, commonly called a "pinched nerve," occurs when a nerve in the neck is compressed or irritated where it branches away from the spinal cord.

This may cause pain that radiates into the shoulder and/or arm, as well as muscle weakness and numbness.

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What are the causes of cervical radiculopathy?

Cervical radiculopathy happens when a nerve root in your neck (cervical spine) becomes compressed (pinched) and inflamed.

This compression has two main causes:

  1. Degenerative changes happen in your spine as you age (cervical spondylosis). As the discs in the spine age, they lose height and begin to bulge. They also lose water content, begin to dry out and become stiffer. As the discs lose height, the vertebrae move closer together. The body responds to the collapsed disc by forming more bone, called bone spurs, around the disc to strengthen it. These bone spurs narrow the small openings on each side of the spinal column where the nerve roots exit and pinch the nerve root.

  2. A herniated (bulging) disc in your neck. A herniated disc causes cervical radiculopathy when the leaked material from a disc in your neck presses on nearby spinal nerves.

Symptoms of cervical radiculopathy

Cervical radiculopathy produces two types of symptoms: local symptoms you may feel in your neck and neurological symptoms appearing elsewhere in your body.

The neck symptoms may include:

  • Neck pain

  • Stiffness

  • Reduced range of motion

Cervical radiculopathy typically only affects one side of your body

Other neurological symptoms may include:

  • Numbness

  • Tingling or a “pins and needles” feeling

  • Muscle weakness

  • Weakened reflexes

When should I seek medical help?

There are circumstances when neck pain might be caused or accompanied by serious issues. If such symptoms are present it is best to seek immediate medical attention to avoid further complications:

  • Pain or stiffness does not go away after a few weeks

  • The pain is disturbing your sleep

  • Painkillers do not work

  • Your pain is caused by a major accident such as a traffic collision or a fall

  • Weakness, numbness, or tingling in limbs

  • Previous history of cancer

  • If you have a fever, chills, or unexplained weight loss

Diagnosis

The earlier cervical radiculopathy is diagnosed, the more successful the treatment is expected to be.

When you go to your doctor, your doctor will ask about your pain symptoms and your past medical history. Then they will perform a physical examination, including palpating the area of pain, and check the range of motion of your neck.

They may also test reflexes in your hands and feet, and check that you have full sensation in all your limbs. Problems with your reflexes or a lack of sensation could indicate nerve damage.

You may be referred for an X-ray, which will show characteristic features of spondylosis, such as the presence of osteophytes (lumps of extra bone). Your doctor may also conduct electrical tests to measure how well the nerves in your arms and hands communicate with your brain through the spinal cord, in order to visualize if there is any nerve damage.

An MRI may be performed as well. An MRI scan is the imaging method of choice for evaluating radiculopathy as it can visualize the compression of the nerve and soft tissue abnormalities, including herniated disks.

Treatment

Fortunately, over 85% of cervical radiculopathy cases get better without any specific treatments within eight to 12 weeks. About 90% of people with cervical radiculopathy have good to excellent outcomes with nonsurgical therapy.

Nonsurgical treatment options include:

  • Physical therapy. Specific exercises can help relieve pain, strengthen neck muscles, and increase flexibility.

  • Medications. In some cases, medications can help improve your symptoms.

    • Nonsteroidal anti-inflammatory drugs (NSAIDs). Anti-inflammatory drugs like aspirin, ibuprofen, and naproxen can help relieve pain and reduce inflammation.

Surgery: Surgery may be recommended if you’re experiencing severe and persistent pain despite trying nonsurgical therapy or if you’re experiencing severe or worsening neurological issues due to cervical radiculopathy.

Prevention of Cervical radiculopathy

You may not be able to prevent cervical radiculopathy, but these steps may reduce your risk:

  • Stay physically active.

  • Maintain a healthy weight

  • Use good posture. Adjust your desk, chair and computer so that the monitor is at eye level. Knees should be slightly lower than hips

  • Take frequent breaks. If you travel long distances or work long hours at your computer, get up, move around, and stretch your neck and shoulders.

  • Prevent neck injuries by always using the right equipment and the right form when exercising or playing sports.

  • Avoid trauma to your neck

  • Avoid carrying heavy bags with straps over your shoulder.

  • Sleep in a healthy position

  • If you smoke, quit. Smoking could accelerate the process of cervical disc degeneration