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Cervical Radiculopathy

 

Introduction

The word 'radiculopathy' means a loss of function related to a nerve root. Cervical radiculopathy describes radiculopathy where it affects the neck, shoulders and arms. The condition is also sometimes referred to as 'brachalgia'. Radiculopathy in general is often described as a 'pinched' or 'compressed' nerve or as 'nerve entrapment' or 'nerve root impingement'.

These nerve roots connect the spinal cord to the upper back, the shoulders, the arms and the hands and control motion and sensation in these areas.

Causes

The primary cause of cervical radiculopathy is an irritation to one of these nerve roots where it connects to the spinal cord. This can in turn be caused for example by…

  • Pressure on the nerve, often from an intervertebral disc bulging out from the spinal column (a 'herniated disc') or an 'osteophyte', which is a bony growth on the side of a verterbra.
  • Swelling around the nerve root.
  • Narrowing of the spinal column ('spinal stenosis').
  • Degenerative disc disease ('spondylosis').
  • Scar tissue from previous surgery.
  • Injury ('trauma').

In most cases more than one of these causes is present.

Symptoms

Symptoms include…

  • Neck pain that extends to the shoulder / shoulder blade and arm (with more severe pain often felt in the arm than elsewhere).
  • Sensations of numbness, tingling and muscle weakness in these areas.
  • Loss of reflexes.
  • Lack of coordination (particularly affecting the hands).
  • Difficulty lifting any weight.
  • Headache.

Tests / Diagnosis

When you visit the doctor, they will evaluate symptoms and conduct a physical examination and also a neurological examination, which will involve testing reflexes, sensation and muscle strength. Other tests may be recommended, such as imaging (x-ray, CT or MRI scans). Further tests may also be required, but rarely.

Symptoms of cervical radiculopathy are similar to symptoms of other conditions, such as musculoskeletal referred pain, which can make the diagnosis challenging, hence the need in some cases for a range of tests.