Cervical radiculopathy, commonly called a pinched nerve, occurs when a nerve in the neck is compressed or irritated where it branches away from the spinal cord. This may cause pain that radiates into the shoulder and/or arm, as well as muscle weakness and numbness.
Cervical radiculopathy is often caused by wear and tear changes that occur in the spine as we age, such as arthritis. In younger people, it is most often caused by a sudden injury that results in a herniated disk. In some cases, however, there is no traumatic episode associated with the onset of symptoms.
What are the symptoms of a pinched nerve?
Symptoms of a pinched nerve in the lower back include:
A sharp pain in the back that may travel all the way to your foot—pain may become worse with certain activities like sitting or coughing
Numbness of the skin in areas of the leg or foot
Weakness in the leg
Symptoms of pinched nerve in the neck include:
A sharp pain in the arm
Pain in the shoulder
A feeling of numbness or pins and needles in the arm
Weakness of the arm
Worsening pain when you move your neck or turn your head
Diagnosis
Physical Examination
After discussing your medical history and general health, your doctor will ask you about your symptoms. He or she will then examine your neck, shoulder, arms and hands—looking for muscle weakness, loss of sensation, or any change in your reflexes. Your doctor may also ask you to perform certain neck and arm movements to try to recreate and/or relieve your symptoms.
Tests
X-rays. These provide images of dense structures, such as bone. An x-ray will show the alignment of bones along your neck. It can also reveal whether there is any narrowing of the foramen and damage to the disks.
CT Scans. More detailed than a plain x-ray, a CT scan can help your doctor determine whether you have developed bone spurs near the foramen in your cervical spine.
MRI scans. These studies create better images of the body's soft tissues. An MRI of the neck can show if your nerve compression is caused by damage to soft tissues—such as a bulging or herniated disk. It can also help your doctor determine whether there is any damage to your spinal cord or nerve roots.
Electromyography. Electromyography measures the electrical impulses of the muscles at rest and during contractions. Nerve conduction studies are often done along with EMG to determine if a nerve is functioning normally. Together, these tests can help your doctor determine whether your symptoms are caused by pressure on spinal nerve roots and nerve damage or by another condition that causes damage to nerves, such as diabetes.
How is a pinched nerve treated?
In many cases, these simple steps may treat your symptoms:
Medicine such as nonsteroidal anti-inflammatory drugs (NSAIDs), narcotic medicines for more severe pain, and muscle relaxants
Losing weight, if needed, with diet and exercise
Physical therapy or a supervised home exercise program
For a pinched nerve in the neck, wearing a soft collar around your neck for short amounts of time
Some people need more advanced treatments. Your healthcare provider might suggest injections of steroid medicine in the area where a disk is herniated. Some people might benefit from surgery. During a surgical procedure called a discectomy, the surgeon removes all or part of the disk that is pressing on a nerve root. Along with this procedure, the surgeon may need to remove parts of some vertebrae or fuse vertebrae together.
