Cervical Radiculopathy: Causes, Symptoms, Diagnosis, Treatment, and More
Get informed about cervical radiculopathy with our easy-to-navigate Table of Contents. Discover the causes, symptoms, diagnosis, treatment, exercises, stretches, prevention, recovery, and more. Learn about how cervical radiculopathy can impact different aspects of your life such as sleep, driving, exercise, work, pregnancy, weight loss, stress, anxiety, depression, pain management, and alternative medicine. Find support with our helpful resources and improve your quality of life.
Cervical Radiculopathy Causes
Cervical Radiculopathy is caused by a clinical condition characterized by unilateral arm pain, numbness and tingling in a dermatomal distribution in the hand, and weakness in specific muscle groups. The causes include degenerative cervical spondylosis, discosteophyte complex and loss of disc height, chondrosseous spurs of facet and uncovertebral joints, disc herniation ("soft disc"), intraforaminal radicular pain predominantly, posterolateral most common, between posterior edge of uncinate and lateral edge of PLL, mostly motor symptoms, midline herniation usually presents with myelopathic symptoms, and double-crush phenomenon which is combined cervical root compression and distal nerve compression.
Cervical Radiculopathy Symptoms
Some of the common symptoms of cervical radiculopathy include occipital headache (common), trapezial or interscapular pain, neck pain, may present with insidious onset of neck pain that is worse with vertebral motion, pain may radiate to shoulders, unilateral arm pain, aching pain radiating down arm, often global and nondermatomal, unilateral dermatomal numbness & tingling, numbness/tingling in thumb (C6), numbness/tingling in middle finger (C7), and unilateral weakness, difficulty with overhead activities (C7), difficulty with grip strength (C7).
Cervical Radiculopathy Diagnosis
Evaluation consists of a thorough neurologic examination, cervical spine radiographs including flexion-extension views, and MRI of the cervical spine. Nerve conduction studies may be useful to distinguish peripheral from central process (ALS). Selective nerve root corticosteroid injections may help confirm level of radiculopathy in patients with multiple level disease, and when physical exam findings and EMG fail to localize level.
Cervical Radiculopathy Treatment
Nonoperative treatment is successful in 75% - 90% of patients, with surgical decompression reserved for refractory cases or patients with progressive neurologic deficits. Rest, medications, and rehabilitation including NSAIDS / COX-2 inhibitors, oral corticosteroids, GABA inhibitors (neurontin), muscle relaxants, moist heat, cervical isometric exercises, traction/manipulation, and selective nerve root corticosteroid injections are some of the nonoperative techniques. The operative techniques include anterior cervical discectomy and fusion, anterior cervical foraminotomy, posterior foraminotomy, and cervical disc arthroplasty.
Cervical Radiculopathy Exercises
The exercises that can help in the treatment of cervical radiculopathy include cervical isometric exercises and upper limb tension tests.
Cervical Radiculopathy Stretches
The stretches that can help in the treatment of cervical radiculopathy include the valsalva maneuver, neck distraction test, and Spurling's test.
Cervical Radiculopathy Prevention
The prevention of cervical radiculopathy can be achieved by quitting smoking, maintaining a healthy weight, and avoiding activities that might put undue stress on the neck and spine.
Cervical Radiculopathy Recovery
Return to play is indicated after resolution of symptoms and repeat MRI demonstrating no cord compression. Studies have shown return to play expedited with brief course of oral methylprednisolone (medrol dose pack). No increased risk of subsequent spinal cord injury is associated with return to play.
Cervical Radiculopathy Prognosis
The incidence of cervical radiculopathy is 107.3 per 100,000 men annually and 63.5 per 100,000 women annually with a peak range of 50 to 54 years age. The risk factors include white race, cigarette smoking, and prior lumbar radiculopathy. Nonoperative treatment is successful in 75% - 90% of patients, with surgical decompression reserved for refractory cases or patients with progressive neurologic deficits. Recurrent laryngeal nerve injury (1%) is the most common nerve injury from the operation.
Cervical Radiculopathy and Sleep
The cervical radiculopathy does not have a direct effect on sleep, but the pain associated with it can make it difficult or uncomfortable to sleep.
Cervical Radiculopathy and Driving
Cervical radiculopathy can make it difficult to drive due to arm pain, numbness/tingling, and weakness. In some cases, driving may be restricted until symptoms have subsided.
Cervical Radiculopathy and Work
Cervical radiculopathy can affect the ability to perform certain job duties that require use of the affected arm or require sitting or standing for long periods of time. Work restrictions may be necessary until symptoms have subsided.
Cervical Radiculopathy and Exercise
Cervical radiculopathy can make it difficult to exercise. Depending on the severity of the symptoms, certain exercises may need to be avoided until symptoms have subsided.
Cervical Radiculopathy and Pregnancy
Pregnancy can exacerbate cervical radiculopathy symptoms due to the changes in weight and posture. Treatment options may be limited during pregnancy, and nonoperative techniques may be recommended until after delivery.
Cervical Radiculopathy and Weight Loss
Maintaining a healthy weight can help prevent cervical radiculopathy, as excess weight puts additional stress on the neck and spine. Weight loss can also aid in reducing symptoms and improving overall health.
Cervical Radiculopathy and Stress
Stress can exacerbate cervical radiculopathy symptoms, as it can cause muscle tension and added pressure on the affected nerve(s). Stress reduction techniques, such as deep breathing exercises and meditation, may help alleviate symptoms.
Cervical Radiculopathy and Anxiety
Cervical radiculopathy can cause anxiety due to the pain, numbness/tingling, and weakness associated with the condition. Seeking support from a therapist or counselor may be helpful in addressing anxiety and the emotional aspects of the condition.
Cervical Radiculopathy and Depression
Chronic pain associated with cervical radiculopathy can lead to depression. Seeking support from a therapist or counselor, in addition to treatment of the underlying condition, may be beneficial in addressing depression.
Cervical Radiculopathy and Pain Management
Pain management can be achieved through both nonoperative and operative techniques, including medications, selective nerve root corticosteroid injections, and surgical procedures such as anterior cervical discectomy and fusion, anterior cervical foraminotomy, posterior foraminotomy, and cervical disc arthroplasty.
Cervical Radiculopathy and Alternative Medicine
Alternative medicine techniques, such as acupuncture and chiropractic care, may provide additional pain relief and management of symptoms in some patients with cervical radiculopathy.
Cervical Radiculopathy and Support Groups
Support groups can provide emotional support and a forum for sharing experiences and information related to cervical radiculopathy.
Cervical Radiculopathy and Quality of Life
Cervical radiculopathy can impact quality of life by limiting mobility, causing pain and discomfort, and affecting work and daily activities. Treatment and management of symptoms can help improve overall quality of life.