Cervical radiculopathy (pinched nerve)
A painful shoulder or a weakness in your arm may trace back to a problem in your neck. It’s a condition called cervical radiculopathy. Generally, cervical radiculopathy gets better with pain relief and physiotherapy. Some patients, though, may need to consider spinal decompression surgery to free the nerve. Here’s what you need to know.
What is cervical radiculopathy?
Cervical radiculopathy happens when a nerve in your neck becomes compressed or irritated as it leaves your spinal cord. It’s also known as a pinched nerve.
Your cervical spine is made up of 7 small hollow vertebrae stacked on top of each other. The hollow tunnel through the middle is called the spinal canal. It contains your spinal cord, a tightly wound bundle of nerves linking your brain to your body.
All along your spine, nerves branch off from your spinal canal to enable you to feel and move your body. There are 8 pairs of cervical nerves that emerge from your cervical spine and enable you to:
- Move your head, neck, arms and diaphragm
- Feel sensation in your head, neck, shoulders and arms.
Those nerves exit your spinal cord through small openings between your vertebrae. If something changes in your spine and narrows the space between your vertebrae, your nerve may become pinched or compressed. And that can be quite painful.
Cervical radiculopathy symptoms
Symptoms of cervical radiculopathy may include:
- Pain that radiates down your shoulder and/or arm
- Muscle weakness or numbness.
You’ll experience symptoms along the path travelled by the irritated nerve. The location of your symptoms helps your doctor identify which nerve is involved.
What causes cervical radiculopathy?
As noted above, cervical radiculopathy results if a nerve is pinched or compressed as it travels through a gap between your vertebrae to leave your spine. That may happen if there’s a problem with your vertebrae (bones) or the spongy discs that sit between them.
In older people, cervical radiculopathy may be caused by osteoarthritis, which can affect both your discs and your bones. Osteoarthritis of the spine may lead to a progressive breakdown of your spinal discs and can also cause bony overgrowths (bone spurs) that put pressure on the nerves leaving the spinal column.
Another type of disc problem may also cause cervical radiculopathy. If your intervertebral discs have been placed under more force than they can absorb, you may develop a herniated disc. That may happen in a car accident, for example. It can also happen less dramatically over time. Degenerative disc disease can weaken your discs and make them more prone to herniation. Herniated discs are often experienced in middle age.
A herniated disc changes the layout of your spine, putting pressure on the nerve roots and causing pain. The chemicals released by a herniated disc may further irritate the nerve root and add to the pain.
Cervical radiculopathy treatment
Many people with cervical radiculopathy make a good recovery with minimal treatment. Others, though, find that their pain persists.
When treating cervical radiculopathy, we’re trying to relieve your pain and reduce the risk of it happening again.
Conservative treatment for cervical radiculopathy
We usually start with conservative treatment such as:
- Medication to manage pain, reduce inflammation, ease muscle spasms or help you sleep
- Cervical collars or pillows to provide support to your neck and keep it in a good position
- Physiotherapy to strengthen your neck muscles, improve your range of motion and help you manage pain.
If your symptoms are not improving, we may consider steroid injections to reduce swelling and relieve pain so your nerve can recover.
Most patients recover with conservative treatment. If your symptoms persist despite a long course of conservative treatment, surgery may become a consideration.
Surgical treatment for cervical radiculopathy
The main aim of surgery for cervical radiculopathy is to relieve pressure on the compressed nerves in your neck.
Spinal decompression surgery includes operations such as:
These surgeries are performed to widen a narrowed spinal canal or remove a portion of a herniated disc. They aim to address the underlying cause of cervical radiculopathy by creating space for your nerves to exit your spinal canal freely once more.
How can the Victorian Orthopaedic Spine Service help?
Victorian Orthopaedic Spine Service is here to help you with many different spinal conditions including cervical radiculopathy.
We start by examining you and taking a detailed history of your symptoms. We may order imaging tests to confirm a diagnosis of cervical radiculopathy.
Then we’ll discuss treatment options with you. We’re strong believers in a multidisciplinary approach to spinal care so we work alongside other skilled professionals such as physiotherapists, pain specialists, clinical psychologists, GPs, nurses and occupational therapists either to ensure the success of conservative treatment or to help you in your recovery after surgery.
When surgery does look like the best way forward, we’ll talk through the risks and benefits to help you reach an informed decision.
If you’d like help to ease the causes and symptoms of cervical radiculopathy, please make an appointment with us.
* To receive Medicare rebates for your appointment costs, you will need an up-to-date referral from either a GP (usually valid for 12 months) or from another specialist (only valid for 3 months).
All information is general in nature. Patients should consider their own personal circumstances and seek a second opinion. Any surgical or invasive procedure carries risks.
About Dr David Edis
Dr David Edis is an Orthopaedic and Spine Surgeon. David’s areas of special interest include the management of adult spinal conditions as well as hip and knee replacements. He has extensive experience in all facets of spine surgery from simple to complex, covering cervical to lumbo-pelvic conditions. He is an active researcher and medical educator and believes in lifelong learning. He is constantly updating his skills and helping other surgeons.