Cervical radiculopathy occurs when nerve roots in the cervical spine (the seven vertebrae in the neck) become pinched or irritated. Some patients experience numbness, tingling or weakness; others report pain that ranges from a dull ache to a burning, shock-like sensation. The pain occurs from the neck and radiates into the shoulder, arm, hand or fingers, depending on the particular cervical nerve that is irritated. It generally occurs on just one side of the body.
Cervical radiculopathy can occur without any discernable trigger such as a specific injury. Some patients experience intermittent symptoms that may be resolved with simple home interventions, while others may encounter sudden, acute pain and need immediate medical attention.
What Causes Cervical Radiculopathy?
Cervical radiculopathy is often tied to osteoarthritis and/or cervical stenosis from bone spurs, thickening ligaments or bulging discs that narrow the spinal canal and pinch nearby nerves. It tends to present itself most often in those over 50.[i]
In some cases, the nerve roots become inflamed because the inner material of the cervical disc leaks out (herniates) and pinches adjacent nerves. Herniated discs are more likely to occur from an injury or activities that put a lot of stress on the cervical spine (such as wrestling or weight-lifting) and are the most common cause of cervical radiculopathy in younger people.
In rare cases, cervical radiculopathy may be the result of a cervical tumor or infection. Some patients may be at risk of developing the condition because of congenital anomalies in their cervical spine.
Diagnosis and Relief
To accurately diagnose this condition, a physician will conduct a thorough exam, which may include a physical manipulation called a Spurling’s test to see if compressing the cervical spine can reproduce or (temporarily) worsen the patient’s symptoms.
The physician will also gather information about the patient’s lifestyle (amount of time spent sitting at a computer, engaging in mobile phone use, poor posture, etc.). Imaging tests (x-ray, MRI) may be ordered if the physical exam is not conclusive.
When cervical radiculopathy is diagnosed, a treatment plan will be developed based on the extent and severity of symptoms and may include:
- Activity and posture modification to include limiting strenuous activities and increased posture awareness.
- Physical therapy to improve neck and back strength and flexibility.
- Ice and/or heat therapy to the neck for pain relief.
- Medications such as over-the-counter nonsteroidal anti-inflammatories (NSAIDs) can relieve pain and inflammation related to cervical radiculopathy. When necessary, stronger medications may be prescribed on a short-term basis, including muscle relaxants.
- Epidural injection of corticosteroid medication to reduce inflammation of the cervical nerve root.
- Chiropractic manipulation to adjust the cervical spine for improved mobility.
- Cervical traction to gently increase the space between the cervical vertebrae.
For many patients, pain relief is achieved through a combination of these treatments. Steroid injections can provide acute pain relief so that the patient can pursue other interventions, such as lifestyle changes and physical therapy, for long-term relief.
Without treatment, chronic cervical radiculopathy may get progressively worse and may make routine tasks such as gripping objects, writing, typing or even the ability to zipper or button clothes difficult. Dr. Skaribas is fellowship-trained and double board certified in Pain Medicine and Anesthesiology and has extensive experience in epidural steroid injections to treat cervical radiculopathy.