Cervical radiculopathy refers to the compression or irritation of a nerve root in the cervical spine (neck), leading to pain, weakness, numbness, or tingling in the areas served by the affected nerve, such as the shoulder, arm, or hand.

Causes of Cervical Radiculopathy

The condition arises from various issues in the cervical spine:

1. Degenerative Changes (Cervical Spondylosis)

• Age-related wear and tear in the spine, including:
  • Herniated Disc: A ruptured or bulging disc presses on a nerve root.
  • Bone Spurs (Osteophytes): Bony growths from arthritis can compress nerves.
  • Facet Joint Hypertrophy: Enlargement of spinal joints can narrow the nerve passage.

2. Trauma

• Injuries such as whiplash or neck fractures can damage or compress nerve roots.

3. Cervical Disc Herniation

• A protruding or ruptured intervertebral disc places pressure on the nerve root.

4. Foraminal Stenosis

• Narrowing of the foramina (the small canals where nerve roots exit the spine).

5. Tumors or Infections

• Rarely, growths or infections in the cervical spine can compress nerves.

6. Other Causes

• Conditions like rheumatoid arthritis or ankylosing spondylitis that affect spinal alignment or structure.

Symptoms of Cervical Radiculopathy

The symptoms depend on the specific nerve root affected, commonly from C5 to C8:

• Pain: Sharp, burning pain radiating from the neck to the shoulder, arm, or hand.
• Numbness or Tingling: Sensory changes in the affected nerve distribution.
• Muscle Weakness: Difficulty gripping objects or raising the arm.
• Neck Stiffness: Limited range of motion in the neck.
• Reflex Changes: Diminished reflexes in the arm or hand.

Diagnosis

1. Medical History and Physical Examination
   • Evaluation of pain, range of motion, and neurological function.
   • Spurling’s test: Applying pressure on the neck to provoke symptoms.
2. Imaging Studies
   • X-rays: Identify degenerative changes or alignment issues.
   • MRI: Gold standard for detecting disc herniation, nerve compression, or soft tissue damage.
   • CT Scan: Useful for assessing bony structures.
   • Electromyography (EMG) and Nerve Conduction Studies: Evaluate nerve function and rule out other causes.

Treatment for Cervical Radiculopathy

Treatment depends on the severity of symptoms, with most cases resolving with conservative care.

Non-Surgical Treatment

1. Rest and Activity Modification
   • Avoid activities that exacerbate symptoms, such as heavy lifting or prolonged neck extension.
2. Physical Therapy
   • Stretching and strengthening exercises to improve neck stability and posture.
   • Cervical traction to relieve nerve root compression.
   • Ergonomic adjustments to reduce strain.
3. Medications
   • NSAIDs: Ibuprofen or naproxen to reduce inflammation and pain.
   • Muscle Relaxants: For associated muscle spasms.
   • Neuropathic Pain Medications: Gabapentin or pregabalin for nerve pain.
   • Corticosteroids: Oral or injected to reduce severe inflammation.
4. Ice and Heat Therapy
   • Ice for acute pain and heat for muscle relaxation.

Surgical Treatment

Surgery is considered for persistent or severe cases, especially when there is progressive neurological deficit or intractable pain.

1. Anterior Cervical Discectomy and Fusion (ACDF)
   • Removal of the herniated disc or bone spur and fusion of the vertebrae.
2. Posterior Cervical Laminotomy
   • Relieves pressure on the nerve by creating space within the spinal canal.
3. Cervical Artificial Disc Replacement
   • Replacing the damaged disc with an artificial one to maintain mobility.
4. Foraminotomy
   • Enlarging the foramina to relieve nerve compression.

Prognosis

• Most patients improve with conservative treatment within weeks to months.
• Surgery is generally successful for cases requiring intervention, with significant relief of symptoms.

Prevention Tips

• Maintain good posture while sitting, standing, and working.
• Use ergonomic setups for desks, computers, and other workstations.
• Avoid heavy lifting or repetitive neck movements.
• Perform regular neck and upper back strengthening exercises.
• Address early signs of neck stiffness or discomfort promptly.

If you suspect cervical radiculopathy, consult a healthcare provider for an accurate diagnosis and tailored treatment plan. Early intervention improves outcomes and prevents complications.