What is cervical radiculopathy?
Some people have pain, numbness and tingling that may travel into the shoulder, arm or fingers. This can occur when one or more nerves that go from the spine to the arm get pinched or damaged. People sometimes refer to this as having a “pinched nerve in the neck.”
What are the symptoms?
- Aching or shooting pain travelling into the arm and hand.
- Pins, needles, tingling or numbness in parts of the arm or fingers.
- Weakness with certain activities.
- Symptoms can be worsened with coughing, sneezing, neck movements or straining.
- Symptoms are often made better by placing the hand on the head.
What causes radiculopathy?
- Disc herniation: Rubbery discs sit in between each of the vertebrae (spine bones) to add cushion and allow movement. The discs have a tough outer shell and jelly-like center. The discs can break open and bulge out, causing them to press on or irritate nearby nerves. (A disc that breaks open and bulges is called a “herniated disc.”)
- Cervical spondylosis: Wear and tear changes in the spine can form bumps called bone spurs, which press on nearby nerves. (Often called “spinal stenosis” where the space for the nerve is narrowed)
- There is often no accident to have caused cervical radiculopathy. This is common with most people just waking up with these symptoms.
What tests will I need?
- Imaging tests – like an MRI, or CT scans, create pictures of the inside of the body. These imaging tests can show problems with the spine like those described above. These tests are ordered when your doctor thinks you may benefit from surgery.
- Electromyography (also called “EMG”) – is a test that checks how the nerves are working. It is used to find nerve damage from cervical radiculopathy as well as other nerve problems that can affect the arm.
How is radiculopathy treated?
Many people do not need formal treatment. In 90% of cases, the radiculopathy goes away as the nerves heal. When people do get treatment, it can include:
- Pain medicines that you can get without a prescription like ibuprofen or acetominophen (If these do not work, stronger prescription pain medicines are available like opiate or nerve pain medicines.)
- Powerful anti-inflammation drugs called corticosteroids
- Physical therapy for traction
- Sometimes surgery is needed to relieve the pain
How quickly will I recover?
The symptoms usually improve in a few weeks but pain may last up to 3 – 6 months. In some cases numbness and weakness may take longer and sometimes never fully recover.
How serious is this to my health?
Radiculopathy is not a life threatening condition and can improve over time. Cervical myelopathy however, is a serious condition that happens when the spinal cord is pinched. When this happens a doctor can usually detect it by examining you. A person with cervical myelopathy may have falls from bad balance, poor hand coordination (doing up buttons, typing), or have bowel/bladder accidents.
If the following symptoms occur please see your GP/ emergency urgently: Worsening of arm or leg weakness, falls, difficulty walking, bowel or bladder accidents.
What will surgery do?
Surgery will cut out part of the disc or bone so it is not pushing on the nerve. This is done to relieve pain in the arm, or relieve pressure from the spinal cord if it is being pinched (cervical myelopathy). Even after successful surgery you may still be left with weakness or numbness if the nerve is already damaged.
What should I do while I’m waiting for my cervical radiculopathy to get better?
Avoid heavy lifting, avoid turning your head or looking up/down for long periods of time. We also recommend that you avoid chiropractic manipulation while a nerve is being pinched in your neck causing pain. Try to avoid activities that cause pain to travel down the arm. When the pain is gone you can slowly go back to normal activities and exercise
Some people who would like to try traction can go to Diamond Athletic inside the Pan-Am clinic. Traction can also be applied by a physio or athletic therapist.
I recommend Saunders Cervical Home Trac. This can be rented on a monthly basis. It can be applied several times per day to give relief. Studies show that traction applied lying down is better than traction when you are sitting in a chair because it allows the neck muscles to relax.