Neck and Arm Pain / Cervical Radiculopathy

Cervical radiculopathy is also called pinched nerve, nerve entrapment or nerve root impingement. It occurs when the nerve root connecting the spinal cord is injured or pinched when exiting the spinal canal. Cervical radiculopathy can be caused by herniated disc, bony overgrowths (osteophytes), spinal stenosis and degenerative disc disease.

Symptoms

The cervical nerves control upper body motor and sensory activities. Therefore cervical radiculopathy can affect hand movements and coordination or cause numbness and decreased sensation. The main symptom is a headache or neck pain that spreads into the arm and shoulders. Some people experience lack of coordination, numbness or tingling in fingers or hands, muscle weakness and difficulty lifting.

Diagnosis and Treatment Options

To diagnose cervical radiculopathy diagnostic tests are necessary. These may include x-rays, computed tomography (CT) or magnetic resonance imaging (MRI) scans. A myelography test might be needed to show the anatomy of the intervertebral discs and spinal cord. Other tests might include electromyography (EMG) to measure the electrical activity of the muscles and nerve conduction study (NCS) to evaluate electrical signals as they move through a nerve.

Your medical history is taken into consideration and physical and neurological examination is undertaken. Your symptoms and pain levels are recorded. Your muscle strength and reflexes are charted.

Most people can be treated with anti-inflammatory and pain medications, muscle relaxants or spinal injections. Physical therapy and braces can help support the spine. Traction and acupuncture can also help reduce symptoms.

Surgery might be recommend for those with persistent pain, spinal or neurological problems. The aim of surgery is to decompress nerves and relieve the pressure and to stabilise the spine. Surgical procedures include:

• removing parts of bone or soft tissue causing the compression
• expanding the spinal canal to relieve pressure on the spinal cord and nerves
• removing a herniated or ruptured disc
• fusing vertebrae to stablise the spine, sometimes with the aid of rods, plates and screws.

Recovery

Recovery differs between patients and surgeries. As a general guide the following are consistent with all cervical surgeries:

• Three to five days in hospital
• No heavy lifting for the first few weeks or so (and graduated lifting restrictions thereafter)
• Some time off work in order to recover
• You may need to return to work on restricted duties for a period of time
• You may not be able to drive for 4 to 6 weeks
• No swimming for 4 to 6 weeks
• Physiotherapy
• Pain medication
• Rehabilitation depending on the surgery