What Is Cervical Radiculopathy (Pinched Nerve)?
Cervical radiculopathy is the impairment or damage of the nerve function which is the result of any of the nerve roots that is close to the cervical vertebrae being compressed. Impairment to nerve roots in the cervical area will result in pain and loss of sensation in different parts of the upper extremities, depending on the damaged root.
What are the Causes of Cervical Radiculopathy?
Impairment can be the result of pressure from a ruptured disc, degenerative changes in bones, arthritis or other injuries that causes heavy burden to the nerve roots. This degenerative changes occur as we grow older and they are usually referred to as arthritis or spondylosis. These changes are “normal” and happens to everyone. For those who are aged 50 or older, normal degenerative changes will result in pressure on nerve roots. As for people who are younger than 50 years old, cervical radiculopathy usually occurs by a ruptured disc due to trauma or injury. The material within the ruptured disc put pressure on the nerve root therefore causing pain.
What are the Symptoms of Cervical Radiculopathy?
The pain spreads to the arm, neck, chest, upper back and shoulder depending on the damaged nerve root. The pain is often defined as sharp, “pins and needles” sensation, muscle weakness or even total numbness.
Symptoms may also worsen while doing some activities such as turning the head, extending or straining the neck. Stretching the shoulder by positioning the hand on the head can improve the symptoms.
How is Cervical Radiculopathy Diagnosed?
During consultation with the doctor, he or she will look at your neck and conduct some test to examine the strength, sensation and reflexes and also ways to relief the pain.
What are the Tests for Cervical Radiculopathy?
- Computed tomography (CT)
- Magnetic resonance images (MRI)
What are the Treatments for Cervical Radiculopathy?
Most of the patients with cervical radiculopathy recover without the need for any surgical or non-surgical treatment. For some patients, the pain subsides after a few days or weeks, while other took longer time. Cervical radiculopathy may also reoccur in the future, yet again, the pain will get better without treatment. However for some patient the symptoms may become persistent or even worsen and need to seek treatment for the pain.
Usually the doctor will suggest the patients to seek treatment using non-surgical method before proceeding to surgical treatment.
Soft Collars – Soft collars allow the neck muscle to rest and limit neck movement which will reduce the pain or numbness. Soft collars are advice to be worn for a short period of time as it may weaken the neck muscle.
Physical Therapy – Physical therapy aids in strengthening and stretching the neck muscle.
- Nonsteroidal anti-inflammatories (NSAIDS). Drugs like aspirin and ibuprofen, might be useful if the arm symptoms are from nerve swelling.
- Oral corticosteroids. Oral corticosteroids may relief the pain and swelling
- Narcotics. These medications are only for patients with persistent pain after using other nonsurgical methods. However there are only limited dosages per lifetime to narcotics.
- Spinal injections. Injection of steroids at the area which the nerve is being pinched. The anti-inflammatory effects are the same as oral steroids. The injection may be done in between the laminae (epidural steroid injection), in the foramen (selective nerve injection), or into the facet joint. While steroid injections do not take the pressure caused by a narrow foramen or herniated disk off the nerve, they may lessen the swelling and relieve the pain enough to allow the nerve to recover with more time.
There are several surgical treatments for radiculopathy. The type of surgical treatment depends on the conditions of the patients.