Cervical radiculopathy is the irritation of a nerve in the neck or pressure on nerve roots as they exit the spinal column — commonly referred to as a pinched nerve. The main causes of this condition are degenerative changes, a herniated disc, and spinal instability. Often, the first symptom of cervical radiculopathy is pain or muscle stiffness in the neck region. There can also be pain in the arms, shoulders, back, and chest, as well as weakness or numbness in the hands, arms, and shoulders.
There are a number of causes of cervical radiculopathy. As people age, there are degenerative changes in their bones and soft tissues. Discs in the spine lose their water content and start to collapse, thereby causing the space between the vertebrae to narrow. Facet joints — joints located between and behind adjacent vertebrae — can become enlarged from irritation due to added pressure, thereby pressing against nerves and causing pain.
Cervical radiculopathy can also be caused by a herniated disc. Either the disc can be pushed out of place or the annulus — the outer wall of the disc — becomes injured and ruptures, thus causing material in the nucleus to squeeze out of the disc. A herniated disc may be the result of extra pressure on the nucleus of a disc due to heavy, repetitive lifting, twisting or bending, or it can be a result of natural changes to the annulus. The annulus tends to tear and crack and is repaired with scar tissue, which can make it weaker over time.
Spinal instability is another reason for the onset of cervical radiculopathy. This condition involves extra movement among the bones of the spine, thus placing pressure on the nerves of the neck. It sometimes develops because of torn or stretched supporting ligaments that result from a severe head or neck injury. Also, people with diseases that loosen connective tissue may also develop spinal instability.
Symptoms of cervical radiculopathy are caused by pressure placed on an irritated nerve. Pain in the neck, arms, shoulders, back, and chest is common, as are headaches. Often, there are changes in the nerves, such as numbness, tingling, and weakness in the muscles of the shoulder, arm, or hand. Also, reflexes of the upper arm muscles are commonly affected.
Treatment for cervical radiculopathy will often be non-surgical unless the condition rapidly becomes worse. What method of treatment is used to relieve such symptoms as neck pain and back pain depends on the severity of damage to the disc and vertebrae. Doctors will often encourage immobilization of the neck with a few days of bed rest and use of a soft neck collar for one to two weeks.
Working with a physical therapist is another form of treatment. It is initially performed to ease pain and inflammation. There are various options for physical therapy, such as the use of traction to stretch the joints and muscles of the neck or electric stimulation to calm the pain. Medications may also be prescribed, such as anti-inflammatory medications, muscle relaxants, or narcotics for severe cases of cervical radiculopathy.