What Is Cervical Radiculopathy? Cervical radiculopathy is the clinical description of when a nerve root in the cervical spine becomes inflamed or damaged, resulting in a change in neurological function. Neurological deficits, such as numbness, altered reflexes, or weakness, may radiate anywhere from the neck into the shoulder, arm, hand, or fingers. Pins-and-needles tingling and/or pain, which can range from achy to shock-like or burning, may also radiate down into the arm and/or hand. Cervical Nerve Roots and Radiculopathy There are 8 pairs of cervical nerve roots, numbered C1 through C8, in the cervical spine. These nerve roots branch from the spinal cord and exit both sides of the spinal canal through an intervertebral foramen (small bony opening between the adjacent vertebrae). These cervical nerves then branch out further to supply muscles that enable functioning of the shoulders, arms, hands, and fingers. They also carry sensory fibers to the skin that provide sensation. The most common causes of cervical radiculopathy are when a nerve root becomes inflamed or damaged due to a nearby bone spur or cervical herniated disc, such as from spinal degeneration over time or an injury. Many other less common causes of cervical radiculopathy are possible, such as infection or tumor. The exact mechanism of nerve irritation or damage is not always understood in cervical radiculopathy. Chemical processes related to inflammation are thought to most commonly cause damage to the nerve root that results in radiculopathy, rather than a true mechanical impingement of the nerve root. The Course of Cervical Radiculopathy Cervical radiculopathy is a rare condition that occurs slightly more often in men than women. It is more likely to occur in older people due to spinal degeneration, with some estimates putting the highest risk for ages 50 to 54. When cervical radiculopathy occurs in younger people, it is more likely due to disc herniation or injury. Cervical radiculopathy signs and symptoms most commonly appear intermittently at first—coming and going—but they could also develop suddenly or gradually. Some movements or head positions, such as putting the neck in extension (with the head back), may exacerbate the symptoms in some cases. Most cases of cervical radiculopathy are self-limiting and go away on their own. There is limited evidence for whether any one nonsurgical treatment is more effective than others. In the early stages, most recommendations are to try a combination of one or more treatments, such as rest or activity modification, physical therapy, manual manipulation, ice and/or heat therapy. Common Causes of Cervical Radiculopathy The two most common causes of cervical radiculopathy include: Cervical foraminal stenosis. When a foramen (bony opening where a nerve root exits the spinal canal) narrows and becomes smaller, the nerve root has less space and may become impinged. Degenerative changes related to cervical osteoarthritis and/or cervical degenerative disc disease may result in nearby bone spurs (osteophytes), thickening ligaments, or a bulging disc that pushes against the nerve root in the foramen. Cervical foraminal stenosis is the most common cause of cervical radiculopathy. Cervical herniated disc. If the inner material of the cervical disc leaks out and inflames or impinges the adjacent nerve, it can cause cervical radiculopathy. A herniated disc is more likely to occur from an injury or strenuous activity, which may explain why it is the most common cause of cervical radiculopathy in younger people (20s or 30s). Other Causes of Cervical Radiculopathy While much less common, other potential causes of cervical radiculopathy include: Fracture. If part of a vertebra becomes fractured, the resulting instability or foraminal narrowing in the cervical spine may impinge a nerve root. Such a fracture could be caused by an injury or cervical spondylolisthesis (where one vertebra slips in front of another). Tumor. A tumor, whether malignant or benign, may grow nearby and push against a nerve root. Other conditions may also compress or cause damage to the cervical nerve root. It is also possible for a congenital anomaly to result in a narrowed foramen or other changes that increase the likelihood for cervical radiculopathy to develop. Risk Factors for Cervical Radiculopathy Some factors that may increase the risk for developing cervical radiculopathy include: Age. The risk for cervical radiculopathy tends to increase with age. Some estimates state that this risk peaks in a person’s 40s or 50s. Strenuous activities that are capable of putting high levels of stress on the cervical spine, such as wrestling or weight-lifting. Repetitive neck motions or vibrations, such as driving a truck (vibrating equipment) or repeatedly diving head first from a diving board into a pool. Cervical radiculopathy signs and symptoms typically include pins-and-needles tingling, numbness, and/or weakness in the areas served by the affected nerve root. In addition to these neurological deficits, pain is also present in most cases. These signs and symptoms may be felt in one area only, such as the shoulder, or progress along the entire arm and into the hand and fingers. Cervical radiculopathy signs and symptoms are most commonly on just one side of the body, but they can be on both sides. If neurological deficits become severe or go into the hand, they can reduce the ability to perform many routine tasks, such as gripping or lifting objects, writing, typing, or getting dressed. Neurological Deficits in Cervical Radiculopathy Cervical radiculopathy involves one or more of the following neurological deficits that may be experienced in the neck, shoulder, arm, hand, and/or fingers: Sensory. Feelings of numbness or reduced sensation in the skin. There may also be tingling, electrical sensations. Motor. Weakness or reduced coordination in one or more muscles. Reflex. Changes in the body’s involuntary (automatic) reflex responses. Some examples may include diminished ability to respond when the skin touches hot or cold, or possibly a reduced triceps or biceps reflex when the elbow is tapped by a rubber hammer during an exam. How Pain May Feel with Cervical Radiculopathy Cervical radiculopathy is typically accompanied by some form of radicular pain, but not always. In cases where cervical radiculopathy involves pain, it can range anywhere from a dull, general discomfort or achiness to a sharp, shock-like or burning pain. Cervical radicular pain may be felt anywhere from neck all the way down the arm into the fingers. While a radiculopathy is commonly accompanied by radicular pain, the two are not the same. A radiculopathy involves a neurological deficit, whereas radicular pain can occur without a neurological deficit. It is possible to have cervical radiculopathy with little to no pain in the neck and/or arm, but most cases do involve pain in addition to the neurological deficits. Treatment - Physical therapy. A physical therapist or other certified health professional might prescribe an exercise and stretching routine that is specific for the patient’s needs. Improving the neck and back’s strength and flexibility may help them to hold better posture and become more resistant to pain.