Cervical Radiculopathy

What is cervical radiculopathy?

Cervical Radiculopathy is a condition in which pain is caused by irritated or pinched nerves in the neck that may radiate into the shoulders and arms. The cervical portion of the spine refers to the top seven vertebrae connecting at the skull’s base. These differ from other vertebrae because they have special openings for vessels that bring blood to the brain. The top two vertebrae (called the atlas and axis) are designed specifically for head rotation. Ligaments around the atlas and axis allow for much flexibility, but there is very little muscular support. The remaining 5 vertebrae are designed for looking up and down. For this reason, the neck is prone to injuries caused by a ‘whiplash’ type movement of the heavy skull on fragile bones and tissue. Dr. Brenton Pennicooke, MD, cervical radiculopathy specialist, treats patients in St. Louis, St, Peters, Creve Coeur and surrounding cities in St. Louis county and St. Charles county, Missouri, who are experiencing pain or a pinched nerve in their neck.

What causes cervical radiculopathy?

Cervical radiculopathy is caused by anything that irritates or damages the nerves in the neck. Damage in discs or vertebrae or even arthritis can cause root nerve inflammation. Factors such as age, mobility, lifestyle choices, and overall health can increase the likelihood of these injuries. Common causes of cervical radiculopathy include:

• Herniated (slipped/ruptured) disc: The inner part of the disc slips out, causing a pinched or inflamed nerve.
• Degenerative disc: Normal wear and tear over time causes the disc to thin out and lose its cushioning properties, causing the opening for the nerve root to narrow and pinch.
• Trauma: Accidents, especially those involving a “whiplash” type movement, can lead to injuries in the vertebrae or discs, causing neck pain. Repetitive neck motions may also cause injury.

Less commonly, infections, bone spurs, fractures, and tumors can be the cause of cervical radiculopathy.

What are the symptoms of cervical radiculopathy?

The most common symptom of cervical radiculopathy is neck pain that shoots down the arm into the hands. Specifically, the pain may shoot into the shoulders, arms, hands, upper back, chest, or specific fingers. In addition to pain, other symptoms may include tingling, numbness, and muscle weakness. Symptoms usually present on only one side of the body but may be on both. Severe cases may prevent daily tasks such as writing, gripping, or typing.

How is cervical radiculopathy diagnosed?

Cervical radiculopathy is usually diagnosed by a physical exam and review of the patient’s medical history; however, imaging such as an MRI or CT myelogram is essential to identify the potential cause of radiculopathy. During the exam, Dr. Pennicooke will assess pain level, reflexes, muscle function, and general health.

What is the treatment for cervical radiculopathy?

Treatment for cervical radiculopathy is largely determined by the severity of symptoms and will be unique to each patient. Many cervical radiculopathy cases can be alleviated without surgery, so Dr. Pennicooke recommends beginning treatment with non-surgical options.

Non-Surgical:

Non-surgical options for cervical radiculopathy include managing pain with heat/ice and a prescription or over-the-counter pain medication. A cervical collar may be used to immobilize the neck or a cervical pillow to support the neck while sleeping. Dr. Pennicooke may also recommend steroids (injections or pill form) to decrease inflammation or physical therapy to increase mobility.

Surgical:

If the patient does not experience relief from non-surgical treatment options and is experiencing debilitating pain and impairment of daily activities, Dr. Pennicooke may recommend surgery. The type of surgery will be determined by the injury and it’s severity. Some options include:

• Cervical fusion: Using a small opening in the front of the neck, the damaged disc and fuse two or more vertebrae. This stabilizes the spine and restores it to its normal height giving more room for the nerves.
• Artificial disc replacement: Instead of fusing the spine to create height between the vertebrae, an artificial disc is used to replace the damaged one. This potentially gives the patient more mobility post-surgery.

Some improvement in symptoms may occur with both non-surgical and surgical treatment plans. Typical recovery time after common cervical fusion surgeries is 2 to 3 months. However, the recovery time can be short in specific patients.