With cervical radiculopathy, neurological deficits, such as numbness, altered reflexes, or weakness, may radiate anywhere from the neck into the shoulder, arm, hand, or fingers. Pins-and-needles tingling and/or pain, which can range from achy to shock-like or burning, may also radiate down into the arm and/or hand. The longer that numbness and/or weakness lasts in the shoulder, arm, or hand, the more likely that these deficits will become permanent or lead to paralysis. Should you begin to experience any symptoms, it’s important to see an orthopedic specialist as soon as possible. You’ll find the best at Colorado Center of Orthopaedic Excellence in Colorado Springs, Colorado.

OVERVIEW

Cervical radiculopathy (also known as “pinched nerve”) is a condition that results in neurological dysfunction caused by compression and inflammation of any of the nerve roots of the cervical spine or neck area of the spine. It is a somewhat common condition that affects approximately 85 out of 100,000 people and occurs slightly more often in men than women.  It is more likely to occur in older people due to spinal degeneration, with some estimates putting the highest risk for ages 50 to 54.  When cervical radiculopathy occurs in younger people, it is more likely due to disc herniation or injury. In over half of cervical radiculopathy cases, the C7 nerve root is affected. Approximately a quarter of cases affect the C6 nerve root.

ABOUT THE CERVICAL SPINE

The spine (backbone) is the long, flexible column of bones that protects the spinal cord. It begins at the base of the skull and ends in the tailbone at the pelvis. The cervical spine is the neck region of the spine. It consists of seven bones (C1-C7 vertebrae). Vertebrae help protect the spinal cord from injury. Between the vertebrae in your spine are round cushions called disks. They have soft, gel-like centers and a firmer outer layer, like a jelly doughnut. These disks provide cushioning for the vertebrae, which helps with flexibility. The nerves that run through the cervical spine send messages back and forth between the muscles and the brain. A nerve root is the initial segment of a nerve that leaves the spinal cord. It’s the root of the nerves that extend out to other parts of the body. In a feature unique to the cervical spine, each nerve root from C1 to C7 exits above its corresponding vertebral level. The exception is the C8 nerve root, which exits below the seventh vertebra.

WHAT IS CERVICAL RADICULOPOTHY?

Two conditions are most likely to cause cervical radiculopathy:

• Cervical Spondylosis (Degenerative Disc Disease): The majority of cervical radiculopathy cases are due to cervical spondylosis. This condition involves age-related changes in the discs and joints of the cervical spine. As people age, the discs between the vertebrae can degenerate, leading to loss of disc height and the development of bone spurs (osteophytes). These changes can result in compression or irritation of the nerve roots exiting the spine. Sometimes, this condition is called arthritis or osteoarthritis of the neck.
• Cervical Disc Herniation: This occurs when one of the intervertebral discs in the cervical spine (neck) ruptures or bulges outward, putting pressure on nearby nerve roots. When a disc herniates, its inner layer contains inflammatory proteins that can leak onto the sensitive nerve root. The chemical reaction that is created when these proteins flow onto the nerve root can cause both pain and damage. Herniated discs in the neck are most likely to occur in people ages 30 to 50.

CAUSES

Specific risk factors for developing cervical radiculopathy include:

• Aging
• Repetitive neck motions
• Lack of regular exercise
• Poor posture
• Incorrect lifting or twisting causes additional stress on the neck
• Neck trauma from sports or motor vehicle accident
• Playing golf
• Prior lumbar (lower back) radiculopathy
• Manual labor that involves heavy lifting and/or operating vibrating equipment
• Excessive smoking
• Diving into a pool from a diving board

SYMPTOMS

Cervical radiculopathy signs and symptoms most commonly appear intermittently at first—coming and going—but they could also develop suddenly or gradually. The main symptom of cervical radiculopathy is pain that spreads into the chest, upper back and/or shoulders, arm, hand, and fingers. The pain can range anywhere from a dull, general discomfort or achiness to a sharp, shock-like, or burning pain. Cervical radiculopathy signs and symptoms typically also include pins-and-needles tingling, numbness, muscle weakness, and weakened reflexes in the areas served by the affected nerve root.

NON-SURGICAL TREATMENTS

About 90% of people with cervical radiculopathy have good to excellent outcomes with nonsurgical therapy.

Conservative treatments include:

• Rest and immobilization of the neck
• Non-steroidal medications (NSAIDS) may help with pain and inflammation
• Sometimes a short course of oral corticosteroid medication may be prescribed
• Gabapentin and pregabalin may be used for pain
• Physical therapy may include intermittent traction, and a range of motion and strengthening exercises can help gradually restore areas weakened by pain and disuse
• Epidural steroid injections

WHEN IS SURGERY INDICATED?

When pain and other symptoms go beyond annoyance and start consistently interfering with daily tasks, such as performing job duties, enjoying hobbies, getting enough restorative sleep, or even simply getting dressed, surgery may be an option. Surgery may be indicated if cervical degenerative disc disease symptoms last for 6 months despite trying multiple treatment options. if symptoms of arm weakness or numbness are worsening or severe, or difficulty with walking, coordination, or bowel and bladder control are present, surgery may be recommended much sooner than 6 months. Several different surgical procedures can treat cervical radiculopathy. The procedure your healthcare provider recommends will depend on many factors, including what symptoms you have, your overall health, and the location of the affected nerve root.

GETTING THE RIGHT DIAGNOSIS. GETTING THE RIGHT DOCTOR.

Cervical radiculopathy can be difficult to diagnose, as many other neurological conditions, such as neuropathy, can cause pain and numbness. Several other conditions have signs and symptoms similar to cervical radiculopathy, so getting an accurate diagnosis is important. For example, cervical radiculopathy involves nerve inflammation in the neck whereas carpal tunnel syndrome involves nerve entrapment in the wrist, yet both can have similar hand tingling and numbness symptoms. Distinguishing between the two is important in selecting a treatment plan that targets the actual source of the problem. No one is more experienced and exacting in arriving at precise diagnoses for all forms of cervical radiculopathy than the knowledgeable and experienced orthopedic specialists at Colorado Center of Orthopaedic Excellence in Colorado Springs, Colorado. They start by listening to your symptoms, getting a detailed medical history, and performing a thorough physical exam. Imaging such as an MRI or EMG may be ordered to help determine whether you have cervical radiculopathy and which type. If surgery is needed, their skilled, compassionate, and understanding specialists will take the time to walk you through everything and answer all your questions. At CCOE you can count on getting the best care, and the best outcomes.