Cervical Radiculopathy

What is cervical radiculopathy?

Cervical radiculopathy is a painful condition that happens when a spinal nerve in your neck is pinched or irritated. Nerves control movement and feeling in the body.

What causes cervical radiculopathy?

Changes in the vertebrae (back bones) and discs in the neck can put pressure on a spinal nerve. Discs are natural, spongy cushions between your vertebrae that allow your spine to move. Conditions that can lead to a pinched nerve include:

• Disc damage: A disc in the neck may flatten, bulge, or move over time. An injury can also cause disc damage.
  
  
• Cervical spondylosis: This is when the vertebrae in your neck break down. This normally occurs as you age.
  
  
• Growths: Tumors or cysts (fluid-filled lumps) may grow and press on the nerve.

What are the signs and symptoms of cervical radiculopathy?

The most common symptom is sharp pain that travels from your neck all the way down your arm. You may have pain in your shoulder, chest, and hand. The pain may get worse with movement or when you cough or sneeze. You may also have any of the following:

• Burning or tingling sensations in your neck or arm
  
  
• Numbness or weakness in your arm or hand that makes it hard for you to grip objects
  
  
• Headaches

How is cervical radiculopathy diagnosed?

Your caregiver will ask when and how your symptoms began. He will gently press on your neck to check for tenderness and misshapen areas. He will also check your arms and hands for numbness or weakness. You may have any of the following:

• Provocative tests: Your response to certain movements will help your caregiver decide if you have a pinched nerve in your neck. He will ask you to move your neck, shoulder, and arm in different ways. Some movements will increase your symptoms, while others will make you feel better.
  
  
• X-ray: This is a picture of the bones and tissues in your neck.
  
  
• MRI: Powerful magnets and a computer are used to take pictures of your neck. Your caregiver will use the pictures to check for problems and changes in your nerves, discs, and vertebrae. You will need to lie still during this test. Never enter the MRI room with any metal objects. This can cause serious injury. Tell your caregiver if you have any metal implants in your body. Tell caregivers if you cannot lie still, or if you are anxious or afraid of small, closed spaces.
  
  
• CT scan: A special x-ray machine uses a computer to take pictures of your neck. You may be given dye, also called contrast, in an IV to improve the pictures. Tell the caregiver if you are allergic to dye, iodine, or seafood.
  
  
• Electromyography: This is also called an EMG. An EMG is done to test the function of your muscles and the nerves that control them. Electrodes (wires) are placed on the area of muscle being tested. Needles that enter your skin may be attached to the electrodes. The electrical activity of your muscles and nerves is measured by a machine attached to the electrodes. Your muscles are tested at rest and with activity.

How is cervical radiculopathy treated?

Treatment may be needed to help reduce your pain and numbness. Treatment may also help prevent your pinched nerve from getting worse. Treatment options include:

• Nonsteroidal anti-inflammatory medicine: This group of medicine is also called NSAIDs. Nonsteroidal anti-inflammatory medicine may be given to decrease pain. This medicine can be bought without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems if they are not taken correctly.
  
  
• Opioids: This is a strong medicine given to reduce severe pain. It is also called narcotic pain medicine. Take this medicine exactly as directed by your caregiver.
  
  
• Steroids: This medicine may be given to decrease redness, pain, and swelling.
  
  
• Steroid injections: Steroid injections (shots) in your neck help decrease pain and swelling. You may need more than 1 injection if your symptoms do not improve after the first treatment.
  
  
• Physical therapy: Your caregiver may suggest physical therapy to stretch and strengthen your muscles. Your physical therapist may teach you how to improve your posture and the way you hold your neck. He may also teach you how to remain safely active and avoid further injury. He may also help you develop an exercise program that is safe for your back and neck.
  
  
• Surgery: Surgery may be used to treat a pinched nerve if other treatments have not helped after 6 to 12 weeks. Ask your caregiver for more information about surgery.

How can I care for myself when I have cervical radiculopathy?

• Use ice: Put crushed ice in a plastic bag and cover it with a towel. Place the ice over your neck for as long and as often as your caregiver says you should.
  
  
• Rest: Rest when you feel it is needed. Slowly start to do more each day. Return to your daily activities as directed.
  
  
• Wear a soft collar: You may be given a soft collar to support your neck while you sleep. Wear the soft collar only as directed.
  
  
• Do light stretches and regular exercise: Your caregiver may suggest light stretches to help decrease stiffness in your neck and arm as you recover. After your pain is controlled, you may benefit from regular exercise. Ask your caregiver what type of exercise is safe for your back and neck.
  
  
• Review your work area: A comfortable work area can help prevent neck strain. Ask your employer to look at the position of your desk, chair, phone, and computer. This is sometimes called an ergonomic review.

What are the risks of cervical radiculopathy?

• Pain medicines can cause upset stomach, vomiting, and constipation, or kidney or liver problems. Steroids may have side effects, such as facial redness, weight gain, and mood changes. Steroid injections may not reduce your pain, and can cause severe headaches, infection, an allergic reaction, or nerve damage. A soft collar may make the muscles in your neck tight and weak if worn too long. Surgery risks include infection, damage to the spinal cord or other nerves, and ongoing pain.
  
  
• Without treatment, your pain may not go away. Your pinched and swollen nerve may lead to problems when you move your arms or hands.

When should I contact my caregiver?

Contact your caregiver if:

• You have a fever.
  
  
• You get an upset stomach or vomit after you take your medicine.
  
  
• You are losing weight without trying.
  
  
• Your pain is worse, even with medicine.
  
  
• One or both hands feel more numb than before, or you cannot move your fingers well.
  
  
• You have questions about your condition or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

• You develop a rash or hives (large, itchy bumps) on your skin, or you are having trouble breathing.
  
  

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Learn more about Cervical Radiculopathy