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Cervical Radiculopathy

Radiculopathy occurs when a nerve root is compressed or irritated at the point where it exits the spinal canal. Often called a “pinched nerve,” the pain of radiculopathy is caused by pressure on the nerve. Radiculopathy can occur at any point in the spine. When it occurs in the neck region, it is called cervical radiculopathy.

Cervical Radiculopathy is typically felt as a pain in the neck that travels into the shoulders, arms, and even into the hands and fingers.  Some even describe the sensation like they struck their “funny bone.”

Cervical radiculopathy is brought on by a pinched nerve in the neck. It can cause pain, numbness, even a pins & needles sensation. In the simplest terms – it is like sciatica of the neck and arms.

What is Cervical Radiculopathy?

Cervical RadicCervical radiculopathy refers to the pain caused by the compression or irritation of one, or several nerve roots in the neck (cervical spine).  The nerve roots associated with the cervical spine or neck region travel down to the shoulders, arms, and hands. It is not unusual for cervical radiculopathy to result in pain or unusual sensations in these areas. Cervical radiculopathy may cause tingling, numbness, or sensations of “pins and needles,” as well as pain in shoulders, arms, and hands along with the neck. These nerves may also be involved in helping the body move, so sometimes cervical radiculopathy can affect hand movements or coordination. Muscle weakness can also occur.

Symptoms

The severity of symptoms depends on how badly the nerves are compressed or irritated, as well as which nerves are involved. In general, people with cervical radiculopathy have neck pain that often extends across the shoulders, down the arms, and into the hands.

When motor function is impaired, it may be difficult to raise the arms above the head. Some people report problems lifting things. There can also be a feeling of weakness in the arms.

Symptoms of cervical radiculopathy may come on all at once or they may come on gradually over time. Typical symptoms include:

Mild to severe pain
Numbness in arms and hands
Tingling or “pins and needles” sensations
Muscle weakness
Headaches at the back of the neck

Learn More About the Anatomy of the Spinal Cord

What are the Causes?

neck v3Cervical radiculopathy can often be traced back to a damaged disc. The discs are little “cushions” between the vertebrae that act like shock absorbers. Discs are filled with nucleus pulposus, a substance with the consistency of jelly. When a disc of the cervical spine (neck area) is damaged, bulges, or bursts open, it can lead to cervical radiculopathy. The reasons for this are:

The damaged disc may change its shape and start to put pressure on nearby nerves.
If the substance inside the disc leaks out and gets on the nerves, it can cause irritation and pain.

Degenerative disc disease (DDD) of the cervical spine can also lead to cervical radiculopathy. In this case, the disc is not only damaged, the nearby bone may start to grow bone spurs. These bone spurs can sometimes block or put pressure on nearby nerves. It is also possible for an injury or accident to lead to cervical radiculopathy.

Anyone can develop cervical radiculopathy, but it is more prevalent in adults than children. Since disc disorders tend to be more common in the elderly, cervical radiculopathy affects seniors more.

What are my Treatment Options?

shutterstock_290670881Fortunately, there are many good treatment options for cervical radiculopathy. Every patient is different, so diagnosis usually begins with a physical exam, a medical history, and a neurological exam. Other tests that may be required include:

X-rays of the neck
MRI or CT scan
Nerve conduction studies

Many patients obtain relief from medications, nerve blocks, and/or physical therapy.  A cervical collar can be used to provide temporary support and limit neck motion.

Other nonoperative treatments can include:
 Short-term rest
 Cold & Hot Therapy
 Physical Therapy
 Acupuncture
 Massage

Medications for cervical radiculopathy can include:
 Over-the-counter or prescription pain medication
 Anti-inflammatory medication
 Muscle relaxant medication

Interventional Pain Management Treatments
Interventional techniques can be a faster and more definitive method of pain relief. These treatments are useful in the presence of severe pain that has failed conservative medical treatment and/or medication.

Cervical Epidural Steroid Injection  This procedure is considered a very effective treatment for cervical radiculopathy. It is basically the same treatment a woman will receive during childbirth. Under fluoroscopic guidance, your physician will place a small needle into the epidural space and inject a small amount of medication to eliminate the pain.

Transforaminal Epidural Steroid Injection – This procedure is similar to the one above; however, in this case the medication is focused directly onto the nerve fibers that make up the sciatic nerve – the result is more medication delivered to the affected area.

Spinal Cord Stimulation (SCS) – When the inflammation in and around the affected nerves is too great for an epidural injection, SCS is an excellent and effective treatment option that can eliminate the pain without surgery. In SCS, an electrical pulse is delivered directly to the spine, blocking certain neuron fibers’ access to the brain and consequently the brain’s ability to sense the previously perceived pain. 

Surgery:
shutterstock_111729353
In a minority of cases, the cause of cervical radiculopathy may be something that requires surgery to fix. The presence of neurological deficit, cauda equina syndrome (i.e. loss of bowel and/or bladder control), or other problems, may require a surgical intervention.

Many surgical procedures for cervical radiculopathy are minimally invasive and only require a small incision. In many cases, surgery involves removing the damaged disc. If surgery is suggested, your physician will explain the procedure and tell you the risks and benefits. In many cases, surgery for cervical radiculopathy can be performed on an outpatient basis, or with only a short hospital stay.

Prevention Steps:
Part of treatment will be learning healthy spine habits and making lifestyle changes which may reduce current symptoms and prevent further attacks.

Schedule an Appointment Today

Our doctors at the Ainsworth Institute of Pain Management are experts in using the most cutting edge and advanced methods for treating cervical radiculopathy.  Call and schedule an appointment today with one of our board-certified pain management doctors and find out what treatment options would best suit your symptoms.

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