Why does it occur?

Cervical Radiculopathy is neck pain that radiates or travels into the traps, shoulders, and/or down the arms. These radicular symptoms occur because the nerves emanating from your spinal cord are becoming compressed, often secondary to Arthritis or a Herniated Disc.  Once the nerve is compressed, you may feel symptoms along the nerve’s pathway anywhere from your neck to your fingertips.  The most common causes of cervical radiculopathy are a Herniated Disc or degenerative Arthritis (Spondylosis) that compresses the nerve.

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Symptoms:

Patients often present with neck pain that travels into one or both arms.  Symptoms may include pain, numbness, tingling, burning, muscle spasm, and even weakness. Weakness of the associated musculature is a sign that the nerve compression is more severe and needs to be addressed urgently.

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Diagnostic Testing:

An X-ray may be advised during your office visit with Dr. Steven Lee.  The X-ray is a valuable tool to assess the bones in your spine.  Dr. Lee will assess for any mal-alignment, arthritis spur formation, disc or joint space narrowing, or other bony pathology.  Dr. Lee may also order an MRI if your symptoms are significant, failing to improve over time, or if you have any signs of weakness.

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An EMG (nerve study) may also be considered, especially in a patient that is suspected to have multiple sites of compression.  For example, some patients have neck pain but also have a history of Carpal Tunnel Syndrome.  The EMG may help determine how much nerve compression is coming from each respective site (ie the neck vs the wrist).

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Treatment Options:

Treatment options will vary depending on the severity of symptoms. If weakness is found on examination or perceived by the patient, Dr. Lee will need to evaluate and treat the nerve more urgently.  Physical Therapy is a very important aspect of treatment to strengthen the surrounding musculature of the spine, help alleviate muscle spasms, and decrease pain.  NSAIDs such as Advil or Aleve (if not contraindicated) may be advised to reduce inflammation in the area. If your pain is acute and severe, stronger medications may be discussed to address the pain.  Injections such as an Epidural Steroid Injections (ESI) can be useful to patients with severe pain, significant radicular symptoms, or symptoms that did not improve with Physical Therapy, activity modifications, and/or NSAID use.

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Surgical Treatment:

 

The majority of cervical radiculopathy pain is treated successfully without the need for surgery.  However, surgery will be advised in those patients with progressive neurologic compromise and especially weakness of the muscles.  Surgery can also be performed for those patients with severe pain that is unable to be controlled via nonoperative means, a decision the patient gets to determine. 

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The type of surgery performed will be related to the pathology causing the problem.  This may be anywhere from simply removing a herniated disk, to removing bone spurs, to performing fusions of the joint.  If surgery for this problem is necessary, Dr. Steven Lee will refer you to one of his surgical spine specialists.

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*It is important to note that all of the information above is not specific to anyone and is subject to change based on many different factors including but not limited to individual patient, diagnosis, and treatment specific variables. It is provided as an educational service and is not intended to serve as medical advice.  Anyone seeking specific orthopedic advice or assistance should consult Dr. Steven Lee or an orthopedic specialist of your choice.

 

*Dr. Steven Lee is a board certified orthopedic surgeon and is double fellowship trained in the areas of Hand and Upper Extremity Surgery, and Sports Medicine. He has offices in New York City, Scarsdale, and Westbury Long Island.