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Guide to Cervical Radiculopathy

What is a Cervical Radiculopathy?

Cervical radiculopathy, commonly called “pinched nerve”, is a neuro compressive disorder of the cervical spine (neck) resulting in various neurological findings. When a nerve in the neck is compressed or irritated as it leaves the spinal cord it may cause pain or muscle weakness that is radiated and felt in the shoulder and/or the arm.

What causes a Cervical Radiculopathy?

In younger patient’s Cervical radiculopathy usually happens as a result of a disc herniation (slipped disc) due to an acute injury causing narrowing of the gap where the nerve leaves the spine. Sports injuries are other possible ways of causing damage to the disc if there is forced extension of the spine, any sideways bending or sudden and extreme rotation of the neck.

In older patient’s cervical radiculopathy most often arises as a result of degenerative changes that occur in the spine as we age or from an injury that causes a herniation in the disc. Foraminal narrowing from degenerative changes that causes osteophyte formation ( bone spurs) are more likely to cause cervical radiculopathy as patients age over 40 are less likely to develop a disc herniation due to the reduced water content and increase fibrous content of the disc reducing chances of a disc herniation.

How is a Cervical radiculopathy diagnosed?

In most cases, patients will experience deep aching to burning pain that starts at the neck. The radicular arm pain (numbness, tingling, sharpshooting, electrical pain) may follow a neck injury or may be of a sudden occurrence. Certain neck movements such as bending backwards and rotating the neck may exacerbate the symptoms. Other symptoms that you may experience include; muscle weakness in the shoulder/arm, possible sensory changes and feeling of “pins and needles” in the fingers or hand. Some patients may find some relief by raising and placing their hands on top of their head.

Our practitioners are well experienced in dealing with these types of conditions. They will carry out a complete physical examination once they have had a conversation about your signs and symptoms. The physical examination will involve specific orthopaedic, neurological and range of motion assessments which will further aid in their diagnosis. The practitioner may decide that they may need imaging in which they will refer you out to have done in the form of an MRI.

How is a Cervical radiculopathy treated?

The initial treatment for cervical radiculopathy is always a non-surgical approach. In the acute phase, treatment will focus on centralizing the pain, reducing inflammation and the prevention of further neurological loss. This is then followed by decompression of the nerve root and attempt at reducing the herniation.

Our practitioners will decide what treatment modality is best for you and what you are capable of handling. They will also give out advice on icing instructions and exercises that you can perform at home to speed up the recovery.
Prognosis is excellent with proper treatment. About 90% of patients can tolerate conservative treatment and we expect our patients to show progressive improvement over the first 6-8 weeks.

References

KA. An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part II: guidance and recommendations. Pain physician. 2013 Apr;16(2 Suppl): S49-283. https://europepmc.org/abstract/med/23615883

35. Heckmann JG, Lang CJ, Zöbelein I, Laumer R, Druschky A, Neundörfer B. Herniated cervical intervertebral discs with radiculopathy: an outcome study of conservatively or surgically treated patients. Journal of spinal disorders. 1999 Oct;12(5):396-401. https://europepmc.org/abstract/med/10549703

Vizniak, N., Carnes, M. and Vizniak, N., 2007. Quick Reference Conservative Care Conditions Manual. Vancouver: Professional Health Systems.

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