Cervical Radiculopathy: Radiating Neck Pain

Cervical radiculopathy occurs when a pinched or compressed nerve in your neck (cervical spine) causes pain. Radicular pain may extend beyond your neck, radiating down to your shoulders, arms, and fingers. This type of nerve compression can also cause weakness, numbness, tingling, and reflex problems.

Your neck contains 8 pairs of spinal nerves that control several motor (strength) and sensory (feel) functions. The cervical nerve roots at the top of your neck feed movement and feeling to your head and neck, while the nerves at the bottom of your neck enable motor and sensory function to your arms and hands.

man with neck pain radiating into his shoulderStudies show men are more likely than women to develop cervical radiculopathy. Photo Source: 123RF.com.

If one or more of the spinal nerves in your neck becomes compressed, it can interfere with its ability to function properly. This can result in radiating pain and other symptoms that can affect your neck and other structures in your upper body.

Cervical radiculopathy tends to affect middle-aged adults most, with research showing a mean age at diagnosis of 47.9 years and incidence rates highest for those in the 50-54 age group. Men are more likely to develop cervical radiculopathy than women, and the lower cervical nerve roots are most vulnerable to the condition (the C7 nerve root is most likely to be compressed).1

What Causes Cervical Radiculopathy?

The natural aging process on your spine often causes cervical radiculopathy. Years of wear and tear on your spine can lead to several degenerative spinal disorders, including cervical spondylosis (osteoarthritis), spinal stenosis, and herniated discs. A narrowing of the nerve passageways, protruding intervertebral disc, or bone spur caused by these disorders can put pressure on the spinal nerves in your neck.

cervical  nerve root compressionThere are many different causes of cervical spinal nerve compression that can lead to radicular neck pain. Photo Source: SpineUniverse.com.

While cervical radiculopathy is most often linked to a degenerative spinal disorder, the condition may also be caused by a traumatic injury to the neck (such as whiplash or a sports injury). Less commonly, cervical radiculopathy may be caused by an infection or spinal tumor.

Symptoms of Cervical Radiculopathy

Cervical radiculopathy’s primary symptom is pain that radiates from the neck down to the shoulders, arms, hands, and possibly all the way to the fingers.

This pain is an example of sensory dysfunction. Sensory function is related to feeling. In addition to neck pain, numbness and tingling in your neck and upper body are sensory symptoms associated with cervical radiculopathy.

In addition to sensory symptoms, cervical radiculopathy may also cause motor dysfunction. Motor dysfunction is related to muscles and movement. Weakness and changes in reflexes in your neck and upper body are examples of motor symptoms of cervical radiculopathy.

How Doctors Diagnose Cervical Radiculopathy

A spine specialist has several tools to achieve a cervical radiculopathy diagnosis. During your initial appointment, he or she will review your medical history, ask you to describe your symptoms, and conduct a physical exam in an effort to recreate your neck, shoulder, and arm pain. An example of a test your doctor may use in the physical exam is Spurling’s maneuver, in which your doctor gently rotates your head and applies pressure.

Once your doctor collects the information from your history and physical exam, he or she can further pinpoint the location of nerve compression by ordering imaging tests, specifically an MRI. MRI scans can illuminate the soft tissues in your spine, including your spinal nerves.

Additionally, your doctor may request a pair of diagnostic tests called electromyogram (EMG) and nerve conduction studies if you are experiencing significant upper arm and neck nerve pain and other nerve-related symptoms (like weakness in your neck and arms). These tests help your doctor understand whether nerve damage exists, the cause of that nerve damage, and if the symptoms you’re describing relate to this nerve damage.

EMG and nerve conduction tests are often performed together to help diagnose cervical radiculopathy. During the EMG, your doctor inserts a needle electrode into a muscle. The electrode sends electrical impulses through the muscle that help your doctor understand the surrounding nerve activity. During the nerve conduction test, your doctor applies patches onto your skin that are located near nerves that he or she suspects may be causing your pain. These patches send signals to nearby nerves, and the test measures the speed at which the signals travel along the nerve. Together, the EMG and nerve conduction tests measure the health of your nerves and can confirm whether your symptoms are caused by a nerve problem.

Cervical Radiculopathy: Emergency Symptoms

Once your spine specialist confirms your diagnosis, he or she will develop a cervical radiculopathy treatment plan to relieve your nerve compression and/or prevent it from worsening.

Most cases will be relieved with nonsurgical treatment, but you should contact your doctor if the following occurs:

  • Neck pain does not improve with treatment in the time your doctor expects.
  • Pain worsens despite treatment.
  • You develop new numbness or weakness in your neck, arms, or upper body.
  • You develop a high fever.

Additionally, it’s important to understand that symptoms of cervical radiculopathy affect your upper body—your neck, arms, shoulders, hands, and fingers. If you are experiencing symptoms in your lower body as well, such as weakness in your leg, difficulty walking, and/or lack of bowel/bladder function, you should seek medical attention immediately. These symptoms may indicate cervical myelopathy, a much more serious condition. While cervical radiculopathy is compression of a spinal nerve in your neck, cervical myelopathy is the compression of the spinal cord. When the spinal cord is compressed, it can cause widespread spinal problems and often requires spine surgery to correct.

Updated on: 08/06/19
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Cervical Radiculopathy: Treatment for Radiating Neck Pain
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Cervical Radiculopathy: Treatment for Radiating Neck Pain

Cervical radiculopathy treatments include nonsurgical therapies such as anti-inflammatory drugs, physical therapy and epidural steroid injections. Spine surgery may be recommended if conservative treatments do not manage radiating neck pain symptoms.
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