Cervical Radiculopathy | Pinched Nerve in Neck

What is cervical radiculopathy?

The cervical spine is made up of the first seven vertebrae in the spinal column beginning at the base of the skull. Within these bony vertebrae are nerves that carry electrical messages to all parts of the body. Cervical radiculopathy, also known as a “pinched nerve”, occurs when one of these nerves becomes irritated or compressed, by either bulging or herniated disc material or bone spurs from arthritis, causing pain to radiate into the neck and often the shoulder blade, shoulder, and one of the upper extremities. While adults over the age of 50 are most at risk for developing cervical radiculopathy, a sudden and traumatic injury can cause the onset of cervical radiculopathy in anyone. Dr. Andre M. Samuel, orthopedic spinal specialist serving the Clear Lake, Houston, Sugar Land, Texas area has extensive experience and training from of of the nation’s top hospital for treatment of patients who have experienced cervical radiculopathy. In addition, Dr. Samuel has published extensively on the topic of cervical radiculopathy and conducted research furthering our understanding of this condition.

What causes cervical radiculopathy?

A pinched nerve is often the result of compression, by either bulging or herniated disc (the soft joints between spinal vertebral bones) or bone spurs from arthritis (normal “wear and tear”). This can also sometimes occur as a sudden injury that damages the spinal discs or nerves. As patients age, the space between the spinal discs can dry out from water loss leading to a more rigid structure. The decreased flexibility in these intervertebral discs can lead to a collapse of the disc spaces or loss of height between the disc spaces. Patients may also experience painful symptoms from an injury directly to the cervical spine or from certain pushing, lifting, or twisting motions. These injuries may cause a herniated disc where the disc bulges toward the spinal canal creating pressure directly to the irritated nerve root.

What are the symptoms of cervical radiculopathy?

The most common description of cervical radiculopathy is a sharp or burning pain that begins in the neck and moves into the shoulder and shoulder blade and then into one of the upper extremities. Some other common symptoms of cervical radiculopathy include:

• “Pins and needles” sensation in the hand and fingers of the affected upper arm
• Loss of upper extremity muscle strength
• Decreased sensation
• Neck stiffness that may worsen pain w movement

How is cervical radiculopathy diagnosed?

Cervical radiculopathy is diagnosed after obtaining a medical history and performing a physical examination. Dr. Samuel will evaluate the neck and upper extremities for any signs of decreased sensation, muscle weakness, or abnormalities in the nerve reflexes. To identify the root cause of cervical radiculopathy, advanced imaging such as magnetic resonance imaging (MRI) or nerve conduction studies may be requested.

What is the treatment for cervical radiculopathy?

Non-surgical treatment:

The majority of patients with cervical radiculopathy respond well to conservative therapies. Physical therapy is often recommended as some exercises can increase neck muscle strength, alleviate pain, and improve range of motion. Non-steroidal anti-inflammatory (NSAIDs) and oral steroids can reduce any inflammation that may be the cause of cervical radiculopathy. Dr. Samuel may also referred you to have targeted steroid injection to be administered directly to the affected nerve root. Some patients find relief from wearing a soft cervical collar for a short period of time.

Surgical treatment:

More invasive treatment may be necessary when cervical radiculopathy does not respond well to conservative treatment measures. There are a number of surgical treatment options that can be implemented for cervical radiculopathy including cervical disc replacement, cervical fusion surgery, and laminoplasty (spinal canal enlargement). Dr. Samuel will determine the best surgical procedure based on a number of factors such as current symptoms and the location of the affected nerve root.

• Cervical Disc Replacement (CDR): The herniated disc is completely removed from an incision on the front of the neck and replaced with an artificial disc that preserves motion
• Anterior Cervical Discectomy & Fusion (ACDF). The ruptured disc is completely removed from an incision on the front of the neck. The space is then filled with a bone graft that will fuse to the surrounding vertebrae. This is used for treating discs that have becoming severely arthritic.
• Artificial Disc Replacement. The herniated disc is replaced with an artificial disc to preserve neck motion.
• Posterior Cervical Foraminotomy. The cervical disc herniation is removed through a small incision on the back of the neck. The minimally invasive technique allows less injury to the surrounding muscles and preserves the remainder of normal healthy disc