Summary: People dealing with cervical radiculopathy often complain of pain in the neck, shoulder, and arm. Prescription pain medications are one way to address the problem. But they are not the only way. There are other, better ways to treat cervical radiculopathy.
If you are like most people, you have had the occasion to talk about someone being a ‘real pain and the neck’. Yet the idiom is descriptive of a recognized medical condition known as cervical radiculopathy. Cervical radiculopathy is more than just neck pain. It results from a pinched nerve sending out pain signals that can radiate through the shoulder and all the way down the arm.
Cervical radiculopathy is one of several types of neck pain we treat here at Lone Star Pain Medicine. Rest assured there are treatments that do not require long-term prescription pain medications and invasive surgeries.
The Basics of Cervical Radiculopathy
In terms of medical definition, cervical radiculopathy is considered a neurological condition. It is caused by nerve compression. At its core are eight pairs of nerve roots found in the neck, also known as the cervical spine. If one or more of these nerves are pinched, it is likely to cause pain. Inflammation is also normal.
To understand why, think of your spine as an interstate highway. Your nerves are the highway itself, while nerve roots are like exit ramps. What happens if an accident at an exit blocks the ramp? Traffic backs up. The backed-up traffic can cause all sorts of problems at ramps and in towns further down the line.
In a pinched nerve scenario, nerve compression causes problems in the skin and muscles. That is why a pinched nerve in the cervical spine can cause radiating pain in the arms. The correct nerve signals are not making it through the affected nerve and to the brain. The brain interprets this as pain.
What the Pain Feels Like
A pinched nerve’s main symptom is pain. But there are other symptoms that go with it. Interestingly, people perceive pain in different ways. So you might feel one sensation with cervical radiculopathy while a family member or friend feels a different sensation.
Here are the main symptoms of the condition along with a description of the pain:
- Radicular Pain – Many patients experience what is known as radicular pain. This sort of pain is often described as a searing pain. Some people describe it as a series of electric shocks or ‘lightning bolts’ shooting down the arm.
- Pins and Needles – Paresthesia often accompanies the pain of cervical radiculopathy. This is the classic pins and needles feeling. It can be combined with tingling as well.
- Numbness – In some patients, numbness is a common sensation. This is because of sensory loss as a result of nerve signals not being able to complete their journey. Numbness can affect an entire limb or just certain parts of the hand or fingers.
- Weakness – Some patients also report weakness in the affected arm and hand. They may have a tendency to drop things or experience difficulty buttoning a shirt.
One way to tell if the symptoms you are experiencing are indicative of a pinched nerve in the cervical spine is to place your hand on top of your head. Doing so can offer temporary relief by taking the pressure off the nerve in question. We actually use this test in the exam room if we suspect cervical radiculopathy.
What Causes the Condition
The big question in the minds of many of our patients is what causes cervical radiculopathy. There are a number of conditions that seem pretty common. The first is disc herniation.
The human spine is made up of a series of bones with discs between them. The discs perform two functions: adding flexibility to the spine and providing cushioning between bones. If a disk is herniated – meaning a portion of it protrudes from its normal space – fluid from the disk can leak out and put pressure on nearby nerves. This is actually pretty common in younger cervical radiculopathy patients.
Another common cause is degenerative changes in the spine. For example, a condition known as spondylosis leads to bone spurs growing within the spine. The spurs narrow the already limited space through which nerves pass, creating pressure.
Finally, some cases of cervical radiculopathy are the result of acute trauma. Whiplash is a fitting example. In a car crash, whiplash can significantly shift spinal alignment to the point of causing nerve compression. It can also rupture a disk, creating additional pressure on the affected nerve.
Treatment Options Beyond Pain Meds
Westerners typically turn to pain meds at the first sign of discomfort. Pain medications have their place, but there are better and more effective ways to treat cervical radiculopathy. One of the first things a doctor might recommend is physical therapy.
The McKenzie method of physical therapy emphasizes exercises that essentially ‘move’ pain out of the arm and shoulder and back to the neck. From there, it can be managed with other treatments. Another method is known as nerve gliding. This is a therapy that uses gentle exercises to encourage the affected nerve to slide more smoothly through its pathways.
Physical therapy helps some cervical radiculopathy patients. However, other patients do not respond to it as well as hoped. For them, we need to consider other options, including:
- Epidural Steroid Injections – An epidural steroid injection is a minimally invasive procedure that combines anesthesia with anti-inflammatory drugs injected into the space around the affected nerve. Reducing inflammation ultimately reduces pain.
- Cervical Traction – Cervical traction is a process that gently stretches the neck in hopes of creating space between targeted vertebrae. This takes pressure off the nerve while the body tends to healing itself.
- Acupuncture – As an alternative treatment, acupuncture has been used to alleviate cervical pain for centuries. It is believed that acupuncture’s main mechanism is releasing stress in the muscles trying to protect the neck against whatever caused the nerve compression.
The pain medicine doctors here at Lone Star can treat cervical radiculopathy without recommending long-term pain medication. If you are experiencing persistent pain in your neck, shoulders, or arms, perhaps an appointment with one of our doctors is in order.
FAQs
Is cervical radiculopathy the same thing as a stiff neck?
No, a stiff neck is usually a muscle-related issue. Cervical radiculopathy is a neurological condition involving a pinched nerve.
Can cervical radiculopathy be caused by stress?
While stress does not directly create nerve compression, it can indirectly contribute by creating muscle tension. A tense muscle can put pressure on a nerve, causing pain.
Will cervical radiculopathy go away on its own?
The vast majority of patients will get better on their own. But those who do not see improvement within 4-6 weeks should probably see a doctor.
Do a person’s sleep habits impact cervical radiculopathy?
Yes. Ultimately, relieving pain while the spine heals itself requires maintaining a neutral spine during sleep. A pain management doctor can explain how to do that.
Is the condition remedied with surgery?
Surgery is a treatment option, but it is considered a treatment of last resort. It’s best to try less aggressive treatment options first.
