Cervical Radiculopathy refers to damage or irritation of nerve roots that exit the cervical spine. This is commonly referred to as a pinched nerve.

At each vertebral level in the neck, a nerve exits the spinal cord and travels in a specific path to the skin and muscles of the arms. In the neck, nerves go to different areas in the body, from the shoulders into each finger. Generally, these patterns are the same for all people although there can be slight variation. We refer to this specific map of nerves as dermatomal patterns.

Nerves are responsible for three main functions: pain, sensation and strength. Pain is usually the first sign of nerve irritation and may be felt many different ways such as a deep, dull, and achy pain or a sharp, shooting pain along the path of the nerve affected. Sensation changes tend to occur first as pins and needles or tingling and can progress to numbness. Strength changes may be subtle in certain muscle groups or be quite noticeable. Because the nerves are responsible for these functions, compression (or pinching) of a nerve may result in pain, sensation changes, or weakness at different part of your upper arms.

Treatment

There are many different treatment options available for cervical radiculopathy; recommendations depend on your level of pain, length of symptoms, and degree of abnormal findings on exam. Medications are commonly used to reduce inflammation, control pain, and manage any resulting muscle spasms. You may be prescribed a short course of oral steroids to reduce inflammation and/or NSAIDs (non-steroidal anti-inflammatory drugs), both of which are very effective in reducing overall inflammation. Other conservative treatments include quality physical therapy. Physical therapy is used to assist in calming pain and inflammation, increasing mobility, and improving stability and strength. Physical therapists use many different modalities for spinal rehabilitation including cervical traction, manual manipulation, ultrasound, electric stimulation and dry needling.

When oral medications aren’t effective or symptoms are initially severe enough, steroid injection can be effectively used to control inflammation. The steroid injection delivers targeted steroid medication directly to the affected site and can provide short-term to lasting relief. At the Virginia Spine Institute, the needle placement for steroid injections is guided by x-ray to ensure correct placement.

Surgery may be recommended if symptoms have not responded to conservative therapy or there is significant or dangerous neurological damage. Two of the most common surgeries used to treat a cervical radiculopathy are an Anterior Cervical Discectomy and Fusion (ACDF) and more recently, an Anterior Cervical Discectomy and Disc Replacement (ACDR). These surgeries take out the damaged disc and free up any narrowed space for the nerves. The two surrounding vertebra together will either be fused together or replaced with an artificial disc. Your surgeon will discuss with you which surgery is most appropriate for you.

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