Before attempting to treat cervical radiculopathy symptoms, it is important to first get an accurate diagnosis for the cause of the symptoms. For example, cervical radiculopathy and carpal tunnel syndrome can have similar hand pain and numbness symptoms, so distinguishing between the two is important in selecting a treatment plan that targets the actual source of the problem.
When Cervical Radiculopathy Is Suspected
When a person presents with neck pain or related symptoms, such as pins-and-needles tingling, weakness, or numbness in the shoulder, arm, and/or hand, the doctor will likely start with the following:
- Patient history. By gathering info on the person’s medical background, such as any prior or current illnesses or conditions, accidents or injuries, family history, and lifestyle, the doctor can get a better picture of what might need further investigation for current symptoms.
- Physical exam. The doctor will palpate (feel) the neck for any abnormalities or tenderness, as well as check the neck’s strength and range of motion.
- Spurling’s test. As part of the physical exam, Spurling’s test enables the doctor to see if compressing the cervical spine can reproduce or (temporarily) worsen the patient’s radicular symptoms. This test is typically done by having the patient bend the head to the side where symptoms have occurred, and then the doctor gently applies pressure to the top of the head. This process will cause the cervical foramen—bony holes in the spine where nerve roots exit—to compress and narrow, which might have the effect of compressing a nerve root and reproducing the radicular symptoms that the patient has been experiencing. If Spurling’s test reproduces the patient’s radicular symptoms, then cervical radiculopathy is likely present.
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A positive Spurling’s test is usually enough to safely start a patient on a nonsurgical treatment program for cervical radiculopathy.
Advanced Diagnostic Techniques
In some cases, especially if symptoms have not been subsiding with treatment, the doctor might request more advanced diagnostic techniques, such as:
- Imaging studies. Imaging of the body may show how a herniated disc or bone spur is impeding a nerve root in the neck. Magnetic resonance imaging (MRI) is the most common imaging study used when checking for cervical radiculopathy.
- Electrodiagnostic testing. These types of tests check how nerves are functioning. Two of the most common types of electrodiagnostic tests include electromyography (EMG), which can check nerve functioning in the arm by monitoring electrical activity in the muscle, and nerve conduction studies, which check whether nerves are sending signals at a healthy speed.
Imaging studies can be expensive, and electrodiagnostic testing can be uncomfortable, so these diagnostic methods tend not to be used unless needed.