Cervical Radiculopathy
Overview:
Cervical radiculopathy refers to radiating pain into the arms that originates in the cervical
spine. It is one of the most common conditions affecting patients and leading them to
seek spine consultation. Cervical radiculopathy is generally caused by degenerative
conditions such as a herniated disc or an osteophytic bone spur that is pressing on the
nerve as it exits the spinal cord.
Science/History:
Cervical radiculopathy is one of the most common spinal conditions. It produces pain
radiating into the arms from the neck. The pain may be described as aching or knifelike.
It is often very severe an disturbs sleep. The pain appears to “radiate into the arms
because of the pressure or irritation to the spinal nerve. Depending on which nerve is
affected the pain can be mapped out onto a different part of the arm. If the pain is along
the thumb and first finger distribution the 6th cervical nerve is generally involved. If the
pain is down the back of the upper arm then the 7th nerve is the cause.
Cervical radiculopathy can also refer pain to areas of the back of the neck an shoulder
blade area.
A surgeon’s perspective:
A surgeon finds that treatment of a cervical radiculopathy is generally more
straightforward than other spinal conditions. In this case a nerve is being irritated by
something. The disc, bone or other cause has to be identified and the nerve root has to be
identified. Once proper identification has been performed (usually with MRI) than
treatment can be considered. Many of these conditions are likely to improve with time
and resolve on their own. Some however may require surgical removal. Anterior or
posterior surgery may be advised.
A surgeon is challenged to correlate the radiographic findings of nerve root compression
with the clinical presentation of nerve symptoms. This correlation is crucial to insure the
correct nerve and spinal level is operated on. Based upon the correlation of radiographic
and surgical findings, a likelihood of success can be estimated.
A patient’s perspective:
From a patients perspective cervical radiculopathy can be a real “ pain in the neck.”
Although the pain is generally in the arm it does have a component of neck pain and this
problem is one that wears a person down over time. The severity of the pain and its
constant presence throughout all activities of daily living can be more than a nuisance.
Having to live the pain can be depressing and life changing