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Cascade Orthopaedics Practice Newsletter |
Thanks for being a patient of Cascade Orthopaedics! While many patients visit us for a specific problem, they or their loved ones often have other unrelated orthopaedic concerns. We are producing a monthly newsletter with the intent to provide a source of information and to serve as an educational resource for our patients on some common problems, and give advice on maintaining musculoskeletal health. Our goal is to help you prevent problems, and recognize what conditions might be causing pain and disability. We may also suggest resources that might be available to help you prevent or manage problems. Cascade's Website |
Cervical Radiculopathy
- Do you have a deep neck ache that seems to radiate down to your shoulder and arm?
- Do you have pain or shock-like sensations radiating down from your neck to your hands?
- Do you have shoulder or shoulder blade (scapular) pain but your doctor has told you that your rotator cuff is fine?
- Do you have numbness or "pins and needles" tingling of your hand and fingers but your doctor has told you that you don't have carpal tunnel syndrome?
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 You could be having cervical radiculopathy.
Cervical radiculopathy is the clinical term for pain caused by a "pinched nerve" in the neck. The cervical spine is the neck region of the spine which is made up of your cervical 1 (C1) - cervical 7 (C7) bones (vertebrae), discs, and joints. The spinal disc is a structure between each of the spinal bones that is made up of an outside fibrous structure called the annulus fibrosus that is somewhat more firm. The annulus contains an inside structure called the nucleus pulposus that is more soft and jelly-like. Cervical spinal nerves exit from the spinal cord and spine between two bones at a region called the neuroforamen. The neuroforamen is a short tube area formed by an upper arch and a lower valley. These nerves go through this area then branch out to various regions of the shoulders, arms, hands, and fingers. These nerves carry signals from your brain to your muscles that controls your movement and strength. These nerves also carry sensation/sensory signals from your skin, muscles, joints back to your spinal cord and then to your brain.
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What causes cervical radiculopathy?
Any condition that may irritate, compress, pinch, or injure a cervical nerve can lead to cervical radiculopathy. Some more common causes would include: 
- Disc herniation - If the inside disc material exits or breaks through the outside structure this is a disc herniation and this material can compress and "pinch" your nerves or spinal cord.
- Cervical arthritis and degeneration - Arthritis and degeneration is the wear and tear of our joints, discs, bones and body parts that occurs with time and with use. As a result, the bones can form spurs at different parts of the spine. These spurs can compress or "pinch" your nerves or spinal cord.
- Cervical degenerative disc disease - Also a form of arthritis and degeneration is the wear and tear of your discs. Over time the annulus fibrosus may weaken and begin to bulge out and compress your nerves or spinal cord. As the disc wears out, it may also begin to collapse. If a disc collapses, the neuroforamen can narrow the space for the exiting nerve. This can eventually lead to nerve compression and "pinching."
Cervical radiculopathy symptoms
Patients with cervical radiculopathy will typically feel pain, numbness, tingling, and have weakness in the parts of the neck, shoulder, arm, and hand that the specific injured nerve controls. This pain can be at a general area or appear to travel down the entire arm to the hand in a specific area. The type of pain can vary from being dull, burning, sore and achy, to sharp, radiating, or electric-shock like. Patients might feel numbness or "pins and needle" like sensations. These symptoms may be worsened or improved with certain movements or positions such as with bending, tilting, or rotating your neck.
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Treatments
Many times cervical radiculopathy may improve on its own with time. Thus, the initial treatment is typically non-surgical. However, prolonged compression of neurologic structures could lead to permanent changes or damage to the nerve that will not improve even with surgery. Surgery is typically the last resort and is considered if you have failed non-operative measures or if you have progressive worsening neurologic function. Additionally, surgery could be pursued if you have a correlation among your history, motor/sensory regions for pain and dysfunction, and diagnostic studies. There are multiple treatment options both nonsurgical and surgical. However, the appropriate options will depend on your unique condition and problem and after a spine specialist performs your evaluation and reviews studies and tests.
Nonsurgical treatment
- Medications (NSAIDs, Oral corticosteroids, Narcotic pain medications, Neurologic modulating medications)
- Physical Therapy
- Interventions (Spinal injections)
- Symptomatic treatment modalities (Ice, heat, massage)
- Activity modification
- Time for symptoms to possibly resolve/heal on its own
Surgical treatment
- Anterior cervical discectomy and fusion
- Cervical disc replacement (Disc arthroplasty)
- Posterior laminotomy/microforaminotomy
If you have questions or wish to schedule an evaluation by one of Cascade Orthopaedics' specialists, please call us at (253) 833-7750.
This material presented is for educational and informational purposes only. You should consult a physician or health care provider for actual evaluation, diagnosis, and individual treatment recommendations or advice.
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