Understanding Cervical Radiculopathy: A Quick Guide

What is Cervical Radiculopathy?

Cervical radiculopathy, often referred to as a pinched nerve in the neck, is a condition where nerves emanating from the spine become irritated, leading to pain radiating to the shoulders and arms. The primary issue, despite the intense arm pain, originates in the neck, specifically in the cervical neck radiculopathy region. 

The neck, or the cervical region, consists of seven vertebrae stacked vertically. Each vertebra encases a space for the spinal cord, a crucial bundle of nerves. When these nerves are irritated or compressed, as in cervical pinched nerve cases, it results in the perception of pain, not just in the neck but also in the areas served by the affected nerve.

What Are the Symptoms of a Pinched Nerve in the Neck?

Radiculopathy can manifest with symptoms ranging from mild to severe, and the specific location of these symptoms is determined by the affected nerve root. There are three distinct types of radiculopathy:

• Cervical Radiculopathy: This occurs when there is pressure on a nerve root in the neck. It can lead to weakness, a burning or tingling sensation, and a loss of feeling in the shoulder, arm, hand, or finger.
• Thoracic Radiculopathy: This type involves a pinched nerve in the upper back region of the spine, resulting in pain in the chest and torso. While uncommon, it can be mistaken for shingles.
• Lumbar Radiculopathy: Lumbar radiculopathy is characterised by pressure on a nerve root in the lower back. It may cause hip pain, sciatica (shooting pain in the leg), and, in severe cases, incontinence, sexual dysfunction, or paralysis.

Other symptoms can vary based on the type of radiculopathy, affecting different areas of the back, arms, and legs.

What Are the Causes of Cervical Radiculopathy?

This condition is more commonly observed in middle-aged individuals, and its common causes include:

• Disc Problems: Bulging or slipped discs are frequent contributors.
• Age-related Wear and Tear: As the spine undergoes age-related wear and tear, the exit spaces for nerves leaving the spine can narrow.
• Neck Instability and Loss of Alignment: Issues related to neck instability and misalignment can also play a significant role.
• Other Less Common Causes: This category encompasses fractures, infections, and tumours.

Who Is at Risk for Radiculopathy?

With age, numerous spinal changes occur, and radiculopathy typically affects individuals aged between 30 and 50 years old. The risk of radiculopathy is heightened by conditions such as osteoarthritis, rheumatoid arthritis, and obesity. Other contributing factors include poor posture, spinal abnormalities like scoliosis, and engaging in repetitive movements. Pregnant women face an elevated risk, and there is also a hereditary component, with an increased susceptibility if there is a family history of radiculopathy.

How Is Cervical Radiculopathy Diagnosed?

To diagnose cervical radiculopathy, the healthcare provider will initially gather information about the patient's symptoms and review their medical history. A comprehensive physical examination will be conducted, encompassing an assessment of the neck, shoulders, arms, and hands to identify muscle weakness and assess sensation or reflex issues. The patient may be asked to perform specific movements of the arms or neck to observe the onset or alleviation of pain and other symptoms.

Additionally, the following diagnostic tests may be employed:

• X-rays: These are used to detect vertebral opening narrowing or disk injuries.
• CT Scans: These provide detailed images of the cervical spine, offering further insight into the condition.
• MRI: This imaging technique is employed to examine potential damage to nerve roots or soft tissues.
• Electromyography: This test observes muscle activity during rest and contraction, providing valuable information about muscle function.

When Should One See a Specialist?

Seeking a pain management specialist is crucial if the pain is severe, persistent, and impacts daily life, especially if it is associated with symptoms like weakness or numbness in the arms and hands. One should see a specialist when the pain is:

• Severe or persisting.
• Impacting your daily routine and quality of life.
• Not responding to painkillers or reoccurring on stopping pain killers.
• Associated with weakness, numbness in arms and hands, grip or gait abnormalities.
• Associated with fever and/or weight loss.
• Present in individuals with other coexisting severe medical problems such as those with cancer, on immunosuppressant medicines, or on prolonged steroid.

What Are the Treatment Options for Cervical Radiculopathy?

Treatment for cervical radiculopathy may include home care, medications, surgery or combination of treatments. Home care involves activity restriction, while medications can range from analgesics to muscle relaxants. In severe cases, surgery might be recommended, especially if conservative treatments are ineffective. Surgical options can include discectomy, often performed in a pain management hospital.

Home care

Patients are typically advised to restrict activities that exacerbate pain, and healthcare providers may prescribe a splint, brace, or soft neck collar to immobilise the affected area, facilitating rest. Short-term bed rest or mechanical traction may be suggested to alleviate pressure on spinal nerves. Mechanical traction involves the use of weights or specialised devices to create space between spinal bones. Physical therapy, encompassing hot and cold therapy along with other modalities, may be recommended to strengthen, stretch, and protect the affected area. Weight loss might also be suggested, where applicable.

Medications 

Various medications can be employed to address radiculopathy, including analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen, muscle relaxants, oral corticosteroids, and, for severe pain, prescription opioids. Spinal corticosteroid injections into the affected area may also be considered.

Surgery

If conservative treatments prove ineffective within a specified period (typically 6 to 12 weeks), or if multiple nerves are affected with diminishing nerve function despite treatment, surgery may be recommended. Surgical procedures, such as discectomy, involve removing bone spurs or part of a herniated disc. This may necessitate the removal or fusion of a section of the vertebrae. Surgical risks include infection, bleeding, and anaesthesia-related complications. While some individuals may experience continued pain or residual symptoms post-surgery, it remains a viable option for cases where conservative measures fall short.

Epidural Injection (Nerve Block)

This injection is administered under real-time X-ray guidance, delivering anti-inflammatory medicine into the epidural space in close proximity to the affected nerve. The purpose of this procedure is to aid in recovery by mitigating inflammation and decreasing the sensitivity of the nerves responsible for transmitting pain signals. The relief experienced from these injections may vary in duration, ranging from short-term to long-term, lasting anywhere from days to years. In certain cases, the relief may even be permanent if the original issue causing the pain successfully heals.

These injections play a crucial role in reducing pain, enabling individuals to resume normal activities and actively participate in a physical therapy program.

How Can One Prevent Cervical Radiculopathy?

While complete prevention of cervical radiculopathy may not be guaranteed, there are proactive measures individuals can take to mitigate the risk, including:

• Maintaining a healthy weight.
• Sustaining physical fitness.
• Adopting good posture.
• Incorporating stretching exercises to enhance muscle strength and flexibility.

Conclusion

In order to effectively manage cervical radiculopathy, it is crucial for individuals to understand and address their specific health needs related to this condition. A tailored approach, focusing on the right exercises, posture adjustments, and ergonomic practices, is essential for alleviating symptoms and improving overall spinal health. Regular consultation with healthcare professionals is also key to receiving personalised treatment plans, which can significantly impact recovery and quality of life. At Max Hospital, our team of experts is dedicated to providing comprehensive care and support for cervical radiculopathy patients. We are committed to guiding you through each step of your journey, ensuring that your spinal health and well-being are always prioritised.