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Spine Conditions

Cervical Radiculopathy Treatment Options

Neck pain is a widespread problem that can cause substantial discomfort and disability. Almost 40% of work absenteeism is due to people with a history of neck pain. Cervical radiculopathy occurs when the nerve root of a spinal nerve is compressed or inflamed, commonly called a pinched nerve.

A pinched nerve in the neck causes pain that can spread or radiate beyond the neck down into the arm, chest, shoulders, and upper back. Understanding the causes, symptoms, diagnosis, and treatment options is crucial for managing its impact on an individual’s health and well-being.

Any condition that compresses or irritates a spinal nerve root can result in cervical radiculopathy. The key feature is inflammation, which can occur from an acute disc herniation, causing pinching of a nerve root, and when degenerative changes affect the nerve root.

People in their 30s and 40s typically suffer a pinched nerve from disc herniation or trauma. Disc degeneration is the cause of pinched nerves in people in their 50s and 60s. People in their 70s typically develop a pinched nerve root from wear and tear of changes in the spine, including arthritis. Risk factors for cervical radiculopathy include manual labor with heavy lifting, driving, or operating vibrating equipment. A long history of smoking also increases the risk.

Symptoms of cervical radiculopathy may vary depending on the specific nerve root that is compressed but often include:

  • Pain: Usually felt in the neck, shoulders, arms, and hands. It can be sharp, burning, or dull.
  • Numbness or Tingling: These sensations are often felt in the arms, hands, or fingers.
  • Weakness: Muscle weakness in the arms, shoulders, or hands can affect grip strength and agility.
  • Reduced Reflexes: In some cases, reflexes in the arms or hands may be diminished.

Dr. Ball will review and discuss your medical history and inquire about your work, any history of trauma, and your symptoms and how they impact your life. Cervical radiculopathy typically affects only one side of the neck.

He will perform a neurological examination to assess reflexes, muscle strength, and sensory perception. He will order X-rays to view the vertebrae and show disc space narrowing. A CT scan may be helpful to diagnose acute injuries. An MRI is the preferred test to evaluate for radiculopathies, visualize the spine, and identify the location and cause of nerve root compression and disc herniations. Nerve Conduction Studies and Electromyography (EMG), which measure the electrical activity of muscles and nerves, can confirm nerve compression and its severity.

Treatment for cervical radiculopathy aims to relieve pain, improve function, and address the underlying cause of nerve compression. Most patients will get better with time and will not need treatment. In these cases, patients typically feel better within days or weeks. When it does not resolve independently, evaluation and treatment may be necessary.

Conservative Treatments include:

  • Physical Therapy: An aggressive, well-designed program can provide significant relief. Exercises to strengthen and stretch the muscles in the neck and shoulders can help relieve symptoms.
  • Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), oral corticosteroids, or neuropathic pain medications can help reduce pain and inflammation. Sometimes, a short course of oral steroids may be recommended to reduce swelling and inflammation.
  • Cervical Collar: Wearing a soft cervical collar for a short period can support and limit neck movement, allowing the nerves to heal. A nighttime cervical pillow can help relieve symptoms and aid in sleep during recovery.
  • Studies have shown that epidural steroid Injections can provide significant relief and can help accelerate healing for many patients. This involves injecting steroids directly into the area around the compressed nerve to reduce inflammation and pain.
  • Acupuncture has also been shown to provide significant symptom relief.

When conservative treatments are ineffective and the condition is severe or worsening, surgery may be considered. Surgical options aim to relieve pressure on the nerve root and may involve removing the source of compression, such as a herniated disc or bone spur.

Contact Dr. Hieu Ball to schedule a consultation at his San Ramon. He offers a full range of treatments for neck pain. Dr. Ball offers state-of-the-art patient-centered care for patients with neck, mid-back, and low-back problems. He received his orthopedic and spine surgery residency and fellowship training at Harvard Medical School and UCLA-affiliated institutions. Education included training at Massachusetts General Hospital, Brigham and Women’s Hospital, and Boston Children’s Hospital. Dr. Ball is a double fellowship-trained orthopedic spine surgeon. He received a pediatric spine fellowship at Boston Children’s Hospital and a second adult spine fellowship at UCLA. Dr. Ball offers minimally invasive spine care, and many procedures often may be performed on an outpatient basis in an ambulatory surgical center setting.

References

  • https://orthoinfo.aaos.org/en/diseases–conditions/cervical-radiculopathy-pinched-nerve
  • Magnus W, Viswanath O, Viswanathan VK, et al. Cervical Radiculopathy. [Updated 2024 Jan 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.¬†Available from: https://www.ncbi.nlm.nih.gov/books/NBK441828/
At a Glance

Dr. Hieu Ball

  • Double fellowship-trained orthopedic
  • Orthopedic surgery residency at Harvard Medical School
  • Over 20 years of spine surgery experience
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