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Cervical Radiculopathy: Causes, Symptoms, Diagnosis, Treatment, and Prevention

A cervical radiculopathy is a condition that affects the nerve roots in the neck, resulting in pain, numbness, weakness, or tingling in the arm, shoulder, or hand. It is also known as a pinched nerve.

Causes of Cervical Radiculopathy

Cervical radiculopathy can be caused by various factors that compress or irritate the nerve roots in the neck. Some of the common causes are:

• A person's spine discs and joints may wear out and lose their cushioning function as they age, leading to a narrowing of foramina, which is where the nerve roots leave the spine. Inflammation and pain can result from pressure on the nerve roots.

• A herniated disc is a soft, gel-like structure that acts as an absorber between vertebrae. Sometimes, the disc can bulge or rupture and leak its inner material. This can compress or inflame the nearby nerve root and lead to radiculopathy.

• Trauma to the neck, such as from a car accident, a fall, or a sports injury, can damage discs, joints, ligaments, or bones in the spine. This can result in swelling, bleeding, or fractures that can affect the nerves.

• Other causes: Less common causes of cervical radiculopathy include infections, tumors, sarcoidosis, or congenital abnormalities that affect the spine or the nerve roots.

Symptoms of Cervical Radiculopathy

The symptoms of cervical radiculopathy depend on which nerve root is affected and how severe the compression or inflammation is. Some of the common symptoms are:

• It can start in the neck and radiate to the shoulder, arm, or hand. Certain movements and positions of the neck, such as turning, bending, or extending the neck, can worsen the pain.

• Numbness: The numbness can affect part or all of the arm, hand, or fingers. It can cause a loss of sensation or a feeling of pins and needles.

• Weakness: The weakness can affect the muscles that are controlled by the affected nerve root. It can cause difficulty in lifting, gripping, or holding objects.

• Tingling: The tingling can be felt as a sensation of electric shocks or crawling insects. It can occur along the path of the nerve root or in the fingers or hand.

• Other symptoms: Some people may also experience headaches, dizziness, nausea, or difficulty swallowing or breathing.

Diagnosis of Cervical Radiculopathy

In order to diagnose cervical radiculopathy, a doctor will examine the symptoms, medical history, and possible causes. During a physical exam, the doctor will also look for signs of nerve damage in the neck, shoulder, arm, and hand, such as reduced reflexes, muscle strength, and sensation. A doctor may also order several tests to confirm the diagnosis and identify the exact location and cause of nerve root compression or inflammation. Some of the tests include:

• X-ray: An X-ray can show the alignment, shape, and size of the vertebrae and the spaces between them. It can also reveal any fractures, arthritis, or bone spurs that may affect the nerve roots.

• MRI: An MRI can provide detailed images of the soft tissues, such as the discs, nerves, spinal cord, and muscles. It can show any disc herniation, inflammation, infection, or tumor that may cause radiculopathy.

• CT scan: A CT scan can produce cross-sectional images of the bones and soft tissues. It can also show any calcification, stenosis, or bone spurs that may affect the nerve roots.

• EMG: An EMG can measure the electrical activity of the muscles. It can help determine the level and severity of the nerve damage and rule out other conditions that may cause similar symptoms, such as carpal tunnel syndrome or peripheral neuropathy.

• Nerve conduction study: A nerve conduction study can measure the speed and strength of the nerve signals. It can help locate the site and extent of the nerve compression or inflammation.

Treatment of Cervical Radiculopathy

Treatment options for cervical radiculopathy depend on the cause, severity, and duration of the symptoms. The main goals are to relieve pain, reduce inflammation, restore function, and prevent further damage.

• To manage the pain and inflammation, the doctor may prescribe some medications. In addition to nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, muscle relaxants, such as cyclobenzaprine or baclofen, and narcotics, such as codeine or oxycodone, there are also NSAIDs. Acetaminophen and aspirin may also be recommended over-the-counter pain relievers by the doctor.

• A physical therapist or occupational therapist may be able to help the patient with exercises and techniques to improve range of motion, strength, and flexibility in the neck, shoulder, arm, and hand. Additionally, the therapist may use heat, ice, ultrasound, electrical stimulation, or traction to alleviate pain and inflammation. In order to prevent neck strain and injury, the therapist may also teach the patient some posture and ergonomic tips.

• When symptoms are severe, persistent, or progressive, or if nerve root compression or inflammation is causing serious complications, such as spinal cord compression, loss of bladder or bowel control, or paralysis, surgery may be considered. It depends on the cause and location of the nerve root problem what type of surgery is performed. Some common surgical procedures include:

• A cervical discectomy and fusion (ACDF) involves removing the damaged disc and any bone spurs from the front of the neck that are compressing the nerve root. A bone graft or an artificial device is then inserted between the adjacent vertebrae to stabilize the spine.

• An anterior cervical laminoforaminotomy involves removing part of the back of the neck's lamina (the bony arch) and the foramen (the opening where the nerve root exits the spine). As a result, the nerve root has more space and the inflammation and pressure are relieved.

• Replacing a damaged disc with an artificial one that mimics the function and movement of a natural disc preserves motion and flexibility of the spine and prevents adjacent segments from degenerating.

Prevention of Cervical Radiculopathy

Some of the ways to prevent cervical radiculopathy or reduce the risk of recurrence are:

• Maintaining a healthy weight and avoiding obesity

• Practicing good posture and avoiding slouching or hunching

• Using a supportive pillow and mattress and sleeping in a comfortable position

• Avoiding smoking and excessive alcohol consumption

• Stretching and warming up before exercising or engaging in physical activities

• Avoiding lifting heavy objects or using proper techniques and equipment

• Avoiding repetitive or prolonged movements or positions that strain the neck

• Seeking medical attention for any neck injury or infection

• Following the doctor’s or therapist’s instructions and recommendations for treatment and recovery

Summary

The cervical radiculopathy is a condition affecting the neck nerve roots. It is also known as a pinched nerve. It can cause pain, numbness, weakness, or tingling in the arm, shoulder, or hand. The nerve roots can be compressed or irritated by a number of factors, such as degenerative changes, herniated discs, injuries, or other factors. Symptoms, a physical examination, and some tests, including X-rays, MRIs, CT scans, electroencephalograms, and nerve conduction studies, can be used to diagnose it. Depending on the cause, severity, and duration of the symptoms, it may be treated with medications, therapy, or surgery. By maintaining a healthy lifestyle, practicing good posture and ergonomics, avoiding neck injuries or strains, and seeking medical attention when necessary, it can be prevented or reduced.