Neck and Arm Pain / Cervical Radiculopathy
Cervical radiculopathy, commonly referred to as a pinched nerve, nerve entrapment, or nerve root compression, occurs when a nerve root in the cervical spine (neck) becomes irritated, inflamed, or compressed as it exits the spinal canal. Cervical radiculopathy may be caused by a herniated disc, bony overgrowths (osteophytes), spinal stenosis, or degenerative disc disease.
Symptoms
The cervical nerves control sensation and movement in the shoulders, arms, and hands. As a result, cervical radiculopathy can affect hand and arm function, causing pain, weakness, numbness, or altered sensation. Common symptoms include neck pain that radiates into the shoulder, arm, or hand, as well as headaches, loss of co-ordination, tingling in the fingers or hands, muscle weakness, and difficulty lifting or gripping objects.
Diagnosis and Treatment Options
To diagnose cervical radiculopathy, a thorough medical history, physical examination, and neurological assessment are performed. Your symptoms, pain levels, muscle strength, reflexes, and sensation will be carefully evaluated.
Diagnostic investigations may include X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI) scans. In some cases, a myelogram may be required to assess the anatomy of the spinal cord and nerve roots. Additional tests may include electromyography (EMG), which measures the electrical activity of muscles, and nerve conduction studies (NCS), which evaluate how electrical signals travel through the nerves.
Most patients can be treated successfully with conservative measures, including anti-inflammatory medications, pain relief, muscle relaxants, spinal injections, and physiotherapy. Bracing may help support the cervical spine, while traction and acupuncture may provide symptom relief for some patients.
Surgery may be recommended for patients with persistent pain, progressive neurological symptoms, or spinal instability. The aim of surgery is to decompress the affected nerves, relieve pressure on the spinal cord or nerve roots, and stabilise the spine where necessary.
Surgical procedures may include:
- Removing portions of bone or soft tissue that are compressing the nerves
- Enlarging the spinal canal to relieve pressure on the spinal cord and nerve roots
- Removing a herniated or ruptured disc
- Fusing vertebrae to stabilise the spine, sometimes with the assistance of rods, plates, and screws
Recovery
Recovery varies depending on the individual patient and the type of surgery performed. As a general guide, the following may be expected after cervical spine surgery:
- A hospital stay of approximately three to five days
- Avoidance of heavy lifting during the initial recovery period, with gradual progression of activity as advised
- Time away from work to allow for healing and recovery
- A temporary return to work on modified or restricted duties
- Restrictions on driving for approximately four to six weeks, depending on the procedure and recovery progress
- Avoidance of swimming for four to six weeks
- Physiotherapy and rehabilitation, as required
- Pain management with prescribed medications
Dr Tollesson will provide specific recovery guidelines based on the type of surgery performed and your individual circumstances.
