Cervical Radiculopathy

The Problem

Cervical radiculopathy refers to an irritation or compression of one or more nerve roots in the cervical spine.  Each nerve root supplies a very specific area of the shoulder, arm or hand.  The location of symptoms, which may include pain, numbness, tingling or weakness, is determined by the nerve root structures affected.

Causes

Nerve roots can be affected by a variety of causes.  These include, herniated disc, degenerative disc disease or spinal stenosis.  Please refer to these individual topics within this website for more details.  In some cases, problems outside of the spine can mimic the symptoms of cervical radiculopathy.

Diagnosis

Diagnosis involves a thorough history and physical examination and may include imaging tests, such as MRI, or nerve function testing (EMG).  Dr. Lefkoe’s training in orthopedic, neurologic, rheumatologic and musculoskeletal problems helps him to recognize those problems that can mimic cervical radiculopathy.

Treatment

A variety of medications can be helpful in relieving pain and inflammation.  Muscle relaxants can be used as supplemental treatment.  Physical modalities, such as heat, ice or electrical stimulation can be used for acute pain control and then as needed.  Cervical traction can be useful in providing pain relief.  Exercises are progressed step-wise from range of motion to active stretching and flexibility and finally to strengthening and stabilization, as symptoms resolve.

Epidural steroid injections are useful for patients who have nerve root symptoms and are progressing slowly.  These injections can have value as both diagnostic and treatment procedures.  Epidural steroids treat pain and nerve root inflammation and can provide sufficient relief to permit an aggressive rehabilitation program.

Surgery is indicated if weakness or sensory loss develop in a pattern that follows a specific nerve root or that indicates spinal cord irritation or injury.  Surgery may also be considered if nerve root pain does not respond to non-surgical measures over time.