CERVICAL RADICULOPATHY

What is Cervical Radiculopathy?

Cervical Radiculopathy (CR) refers to a pinched or compressed nerve in the cervical region of the spinal nerves. It usually causes pain, paralysis or weakness extending to the pectoral region (chest) or the arm. Some neurologists often refer to cervical radiculopathy as “Pinched Nerve”.

Certain individuals may misdiagnose peripheral nerve compression syndrome (for example, median and ulnar nerve entrapment) and other pathological anomalies for cervical radiculopathy. Pain from Cervical Radiculopathy could range from slight, general soreness or discomfort to a sharp, stinging sensation. 

If left untreated, cervical radiculopathy can lead to severe neck pain which may radiate to other parts of the body such as the arms, chest, upper back and shoulders. Over time, the weakness in the upper limbs can slow down reflexes, which may reduce coordination ability and affect the person’s day-to-day activities.

What are the Symptoms of Cervical Radiculopathy?

Cervical Radiculopathy signs and symptoms may broadly differ depending on which nerve root becomes affected. For instance, C4 radiculopathy occurs when the nerve root coursing above the C4 vertebra becomes affected. Most cases of Cervical Radiculopathy present with sharp pain and tingling in the neck or arm. Worthy to note; certain other pathologies can present similar symptoms, such as the peripheral nerve compression syndrome previously mentioned. In addition to the sharp pain and tingling sensation, other symptoms of Cervical Radiculopathy may include;

  • Weakness of muscles (hypotonia)
  • Increased sensitivity
  • Pain felt in the back, chest and limbs.
  • Headache 

What are the Causes of Cervical Radiculopathy?

The most prevailing cause of Cervical Radiculopathy results from degenerative changes to the cervical spine over a long period of time. These degenerative changes over time, may present as a feature of old age. Other probable causes of Cervical Radiculopathy include:

  • Fracture. A fracture of the cervical spine or vertebral body may lead to unsteadiness or narrowing of the cervical foramina. This causes “pinching” or compression of the nerve, resulting in pain and discomfort. Causes of fractures of this manner usually involve an injury or spondylolisthesis (where one vertebra slips in front of another).
  • Tumor. Growth of tumors, whether malignant or benign may compress a nerve root if found nearby.
  • Sarcoidosis. An uncommon disease known to cause growth of granulomas (lumps) on any organ in the body.
  • Infection. A variety of spinal infections may inflame and/or damage a nerve root.

Treatment for Cervical Radiculopathy

Cervical Radiculopathy involve various measures. A significant number of options include nonsurgical treatments and surgical treatments. The treatment will depend chiefly on the cause of the patient’s symptoms and the extent of damage to the nerve. Nonsurgical treatments may prove useful first. If symptoms persist after 6 to 12 weeks of treatment, surgical options may come into consideration.

Nonsurgical treatments

  • Physical therapy; developing the strength and flexibility of the neck and back may aid better posture and increase susceptibility to pain and discomfort.  Achievement of this goal becomes actionable with the aid of a physiotherapist or other qualified health care providers.                               
  • Rest; reducing challenging activities such as athletics and weight lifting can limit the work placed on the neck and associated areas. 
  • Postural modification; adjusting posture while sitting or lying down might provide some relief.
  • Use of medications; nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac, ibuprofen and aspirin help to provide relief associated with cervical radiculopathy.

Surgical treatments

These options may be considered if non-surgical treatments prove ineffective.

This surgical procedure involves going through a small incision in front of the neck to excise the herniated disc. The cervical spine at the level of the excised disc then fuses to restore normal height. This provides sufficient space for the spinal nerves and maintains stability of the neck. Maintain

  • Artificial disc replacement

An alternative to ACDF. The damaged or herniated disc gets replaced with an artificial disc. A great advantage of this procedure; mobility at the level of the cervical spine remains sustained, rather than fusing two cervical vertebrae together.

 

References 

Meyler, Z (April 2019). Cervical Radiculopathy (https://www.spine-health.com/conditions/neck-pain/cervical-radiculopathy-treatment).

Nazario, B (September 2020). (https://www.webmd.com/pain-management/pain-management-cervical-radiculopathy)

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