What’s Cervical Radiculopathy?
Cervical radiculopathy (sometimes called “a pinched nerve”) is the damage or disturbance of the cervical nerve root function that results if one of the nerve roots near the cervical vertebrae being compressed.
Damage to cervical nerve roots in the cervical area can cause neck pain and the loss of sensation along the nerve pathway into the arm and hand, depending on where the damaged roots are located.
There are various reasons why one can develop cervical radiculopathy including degenerative changes, problems with the bone or tissues of the cervical spinal column, disc herniation, degenerative disc disease or spinal stenosis.
Cervical Radiculopathy Symptoms
Since these nerves travel to the shoulders, arms and hands, a nerve problem in the cervical vertebral column can causes symptoms in one or several of these areas, leading to widespread and intense pain.
What this means is that although the problem is in the spine, the symptoms may be felt in the shoulder, the arm, or the hand. The symptoms will be felt in the area where the irritated nerve travels. By looking at where the symptoms are, we can usually tell which nerve is involved.
When you are suffering from a cervical radiculopathy, there is usually also neck pain and headaches in the back of your head. These are sometimes referred to as occipital headaches because the area just about the back of the neck is called the “occiput.”
Pain Management Treatments for Cervical Radiculopathy Include:
Common Causes of Cervical Radiculopathy
There are several causes of Cervical Radiculopathy with the most common being a herniated cervical disc, cervical spinal stenosis and cervical degenerative disc disease.
Cervical Herniated Disc
If the inner material of the cervical disc leaks out and inflames or impinges the adjacent nerve, it can cause cervical radiculopathy. If a younger person (20’s or 30’s) has cervical radiculopathy, the most likely cause is a herniated disc.
Herniated discs are more common in early middle-aged adults. This condition may occur when too much force is exerted on an otherwise healthy intervertebral disc. An example would be when your head is hit during a collision, be it in an auto accident or in competitive sports. The force on the neck is simply too much for even a healthy disc to absorb and injury is the result.
A herniated disc may also occur in a disc that has been weakened by the degenerative process. Once weakened, less force is needed to cause the disc to tear or rupture. However, not everyone with a ruptured disc has degenerative disc disease. Likewise, not everyone with degenerative disc disease will suffer a ruptured disc.
Cervical Spinal Stenosis
Cervical spinal stenosis is the narrowing of the spinal canal in the neck. … Squeezing the nerves and cord in the cervical spine can change how the spinal cord functions and cause pain, stiffness, numbness, or weakness in the neck, arms, and legs. It can also affect your control of your bowels and bladder.
Spinal stenosis is a common cause of cervical radiculopathy symptoms in people over age 60.
Cervical Degenerative Disc Disease
When a disc in the cervical spine degenerates, the disc becomes flatter and stiffer and does not support the spine as well. In some people, this degenerative process can lead to inflammation or impingement of the nearby nerve root.
Cervical degenerative disc disease is a common cause of radiculopathy in people over age 50.
Diagnosing Cervical Radiculopathy
For starters, you will absolutely need a physical examination. After talking about your health, background and general health, your doctor will ask you about your symptoms. They will then examine your throat, shoulder, arms and hands, searching for muscle weakness, loss of sensation, or any changes on your reflexes.
Your physician may ask you to execute specific arm and neck movements to attempt to re-create or find a position that lessens your pain.
Cervical Radiculopathy Tests
These will show you bone structure, their alignment of the bones around your throat. They can also show if there’s any narrowing that might be causing issues with your cervical spine.
A CT scan (which stands for “also known as “computed tomography scan”) give a lot more detail than the usual x ray, a CT scan and can help determine whether you’ve developed bone spurs around or near your cervical spine.
MRI’s (aka “magnetic resonance imaging” give your doctor fantastic images of the human body’s soft tissues, something that x-rays simply cannot do.
An MRI of the throat lets us know if if your nerve compression is because of damage to soft tissues, such as a herniated disc or bulging disc. An MRI will also show if your spinal cord or the nerve roots have any damage.
Electromyography (aka “EMG”) measures the electrical impulses of certain muscles when they are relaxed (or at rest) and while working (contracting).
Nerve conduction study
A neve contraction study is often done together with EMG to learn if a nerve is working normally. When done together, these tests can assist your doctor figure out which of your symptoms are from nerve roots pressure or because of a different condition that can cause nerve damage, such as diabetes.
Cervical Radiculopathy Treatment Options
There are a broad range of treatments available for cervical radiculopathy. The specific treatment that a patient will undergo depends mainly on the underlying cause and the severity of its symptoms.
As specialists in non-surgical treatments for pain management of the musculoskeletal system, we promote a more conservative initial approach to treatment. One that is less invasive and very successful in the majority of cases. These treatments might be something as simple as a wearing a cervical collar. These soft cervical collars lets your neck muscles rest because you are limiting neck motion. This helps decrease the pinching of the nerve, allowing the nerves and inflammation to “calm down.”
Medications are often used to treat several of the issues you may encounter. For example, anti-inflammatory drugs decrease inflammation. These include prescription steroids, powerful anti-inflammatory drugs to decrease inflammation, but should be not be used long-term. There are also over-the-counter oral nonsteroidal anti-inflammatory drugs (NSAIDS) such Advil and Motrin, which can be effective. Please note that anti-inflammatory medication should always be taken with food
Other medications like muscle relaxers, which can help control anxiety while also reducing some muscle spasms.
Other conservative treatments include physiotherapy, which is used to sooth pain and inflammation, increasing mobility and enhancing strength and stability. Physical therapy is often recommended and can help in the rehabilitation of the spine. These modalities include cervical traction, manual manipulation and electrical stimulation, to name a few.
Each patient is different and our individualized approach to care and Dr. Vahedifar’s nearly two decades of experience are two key reasons we have among the highest success rates in the country.
Articles and studies of note: