Usually, when something hurts, you don't have to look
far to find the source of the pain. But an injury at the root of a nerve
could result in pain at the end of the nerve, in the neck, shoulder, or
arm, where sensation is felt. For example, an injury to the vertebrae or
disks in your neck (the cervical spine) could result in pain, numbness or
weakness in your shoulder, arm, wrist or hand. Quite simply, an injury to
the cervical nerves can cause problems far away from the neck, because the
nerves that extend out from between the cervical vertebrae provide sensation
and trigger movement in these areas. When the nerves are pinched or damaged,
this condition is called cervical radiculopathy (ra-dick-you-lop'-a-thee).
Causes of cervical disc herniation radiculopathy
Several conditions can put pressure on nerve roots in the neck. The most
common causes for cervical radiculopathy are:
Herniated cervical disk
In this situation,
the outer layer (annulus) of the disk cracks and the gel-like center (nucleus)
breaks through. This causes the disk to protrude, putting pressure on the
nerve that exits the spinal column at that point. A rupture, slip, or herniation
all represent the same problem with the disc.
Spinal stenosis
Sometimes, arthritis and disc bulging can limit the
space in the center of the vertebrae. This narrows the room around the
spinal cord and can place pressure on the cord itself. The irritation
of the spinal cord is called myelopathy (my-lop'-a-thee).
Degenerative disk disease
As we age, the water content in our discs
may decrease causing the discs to be less of a cushion for the spinal
vertebrae. Without sufficient cushioning, the vertebrae may begin to
press against each other. This can cause grinding neck pain, shooting arm
pain, or gradual loss of strength and sensation. Degeneration often forms
bone spurs as a part of this process.
Diagnosis and treatment
Your physician will give you a careful examination and ask about your
symptom history. You may be asked to tilt and rotate your neck to reproduce
the pain symptoms in either the neck or arms. An X-ray will usually show
degenerative disk problems and bone spurs, but gives little information
about the spinal cord or nerve roots. Sometimes your physician may request
an MRI (magnetic resonance image) or a CT scan (computed tomography) using
a colored dye to outline the nerves. Initial treatment is usually conservative
and aims to reduce the pain by easing the pressure on the nerves. The
treatment typically consists of three parts: rest, medication and physical
therapy.
Rest
You may have to take it easy for a few days or wear a soft cervical
collar to limit motion and relieve irritation on the nerves.
Medication
Your doctor may prescribe a non-narcotic pain medicine and
anti-inflammatory drugs to relieve any swelling.
Physical therapy
After muscle spasms subside, your spinal surgeon may
prescribe a cervical traction device or other types of physical therapy
such as heat or cold therapies, electrical stimulation, or isometric
and stretching exercises.
If conservative treatment doesn’t relieve your pain over the course
of 6 to 12 weeks, surgery may be an option. The surgical procedure will
depend on the underlying condition. Your spinal surgeon will discuss the
options with you. In most cases, surgery not only relieves the pain, but
also improves functioning and movement of the affected areas.
