Cervical radiculopathy is the clinical description of pain and neurological symptoms resulting from any type of condition that irritates a nerve in the cervical spine (neck).
Cervical nerves exit the cervical spine (neck) at each level, C1 - C7. Nerves in the neck exit above the designated vertebral level at all levels except the last one (C8 exits below the C7 vertebra), and then branch out to supply muscles that enable the shoulders, arms, hands and fingers to function. They also carry sensory fibers to the skin and muscles that provide sensation.
When any nerve root in the cervical spine is irritated through compression or inflammation, the symptoms can radiate along that nerve's pathway into the arm and hand.
The patient's specific cervical radiculopathy symptoms will depend primarily on which nerve is affected. The symptoms may also be referred to as radicular pain.
Causes of Cervical Radiculopathy
Any condition that injures or somehow irritates the cervical nerve can cause cervical radiculopathy. The most common causes include:
- Cervical Herniated Disc. If the inner material of the cervical disc herniates, or leaks out, and inflames and/or impinges on the adjacent nerve, it can cause a cervical radiculopathy.
- Cervical Spinal Stenosis. As part of the degenerative process of the cervical spine, changes in the spinal joints can lead to tightening of the space for the spinal canal.
- Cervical Degenerative Disc Disease. When the cervical spine degenerates over time, it can result in degenerated discs and a pinched nerve.
Read more: Cervical Stenosis with Myelopathy
Infrequently, cervical radiculopathy can be caused by other conditions, such as a tumor, fracture or sarcoidosis, which can compress or cause damage to the cervical nerve roots.2
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Cervical Radiculopathy Symptoms
Patients with cervical radiculopathy typically feel pain, weakness or numbness in the areas served by the damaged nerve. Pain can be in one area only, like the shoulder, or progress along the entire arm.
The type of pain also can vary. Some patients describe dull, all over pain; others describe the pain as severe burning or sharp. Patients may feel tingling, "pins and needles," or numbness.
Certain neck movements, like bending the neck back, side to side, or rotating it, may increase the pain. Some patients report that pain decreases when they place a hand behind their head; the movement may be relieving the pressure and traction on the nerve root which then lessens their symptoms.
Types of Cervical Radiculopathy
Cervical radiculopathy symptoms differ depending on which nerve is affected. For example, if the nerve root that runs above the C6 vertebra is affected, a physician will use the term “C6 radiculopathy”.
While any patient's specific symptoms can vary widely, the following are common descriptions for the types and symptoms of cervical radiculopathy:
- C5 radiculopathy can cause pain and/or weakness in the shoulders and upper arms. Especially may cause discomfort around the shoulder blades. It rarely causes numbness or tingling.
- C6 radiculopathy (one of the most common), causes pain and/or weakness along the length of the arm, including the biceps (the muscles in front of the upper arms), wrists, and the thumb and index finger.1
- C7 radiculopathy (the most common) causes pain and/or weakness from the neck to the hand and can include the triceps (the muscles on the back of the upper arms) and the middle finger.2
- C8 radiculopathy causes pain from the neck to the hand. Patients may experience weakness in hand grip, and pain and numbness can radiate along the inner side of the arm, ring, and little fingers.
Cervical Radiculopathy Treatment
There is a wide range of treatment options available for cervical radiculopathy, and the treatment will depend mainly on the underlying cause of the patient's symptoms as well as the severity of symptoms:
- Wainner RS, Gill H, “Diagnosis and Nonoperative Management of Cervical Radiculopathy,” Journal of Orthopaedic & Sports Physical Therapy, 2000;30(12):728-744.
- Radhakrishnan K, Litchy WJ, O'Fallon WM, Kurland LT, “Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990,” Brain 1994;117(2):325-335.