A pinched nerve in the neck may be the source of significant pain in the shoulder. The pain may even radiate down the arm and cause muscle weakness, as well as tingling and numbness in the hands and fingers. This painful condition is known as cervical radiculopathy. It can have a major impact on the ability to carry out routine daily tasks.
What is cervical radiculopathy?
This is the medical term for a pinched nerve in the neck where it branches away from the spinal cord. The nerve root becomes irritated or inflamed, resulting in pain and neurological symptoms such as weakness and numbness in the shoulder or arm. The pain may feel like pins and needles or more like shock waves radiating down the arm. There are eight pairs of nerve roots in the cervical spine, and any of them may be affected.
What are its causes?
A cervical herniated disc is one cause of cervical radiculopathy. Discs are the spongy pads that act as shock absorbers to cushion the spine and prevent vertebrae from grinding against one another during movement. Injury or trauma can lead to herniation. Discs also wear out with age and become less flexible. As the outside of the disc weakens, it may develop cracks or tears. This allows the gel-like inner portion of the disc to leak out and cause irritation and inflammation of the nerve root.
Degenerative disc disease can cause cervical radiculopathy. As the joints of the spine wear out, arthritis and bone spurs may develop. If this leads to enough irritation in the neck, nearby nerves may become affected. Bony growths, or bone spurs, can begin to pinch the nerves, also causing pain.
Cervical stenosis may contribute to cervical radiculopathy in older patients. Stenosis is a narrowing of the spaces within the spine. This places pressure on the spinal cord and the nerves in that area. Stenosis may happen with age-related wear and tear or some type of injury or trauma.
What are the treatment options?
If the pain from cervical radiculopathy is not severe, the patient may improve with rest, activity modification, ice or heat therapy, and pain medication such as anti-inflammatory drugs. Cervical traction may help to relieve the nerve impingement.
For more severe pain, physicians often recommend physical therapy, or functional rehabilitation. Common physical therapy treatments for cervical radiculopathy include manual orthopedic manipulation, soft tissue massage, ultrasound, electrical stimulation, and therapeutic exercises to build strength, increase flexibility, and relieve stiffness and pain.
Other treatments that may be considered are cervical epidural steroid injections, nerve blocks, and radiofrequency nerve ablation for pain management. This may be helpful in cases of acute pain or chronic conditions.
When nonsurgical treatments are not successful, neck surgery may need to be considered. Anterior cervical discectomy with fusion (ACDF) is often performed for cervical radiculopathy.
Next Steps
The physicians at Atlanta Brain and Spine Care are experts in the diagnosis and treatment of conditions affecting the spine. Many neck injuries will require only short term care. Contact us today to schedule an appointment.