What is cervical radiculopathy?
Each nerve root leaves the spine through a small opening between two vertebrae and travels to a defined area of the shoulder, arm, and hand. A herniated disc or a bone spur can narrow that opening and irritate the root. Because each root serves a known territory, the pattern of symptoms usually points to the level involved before any imaging is done.
Symptoms
- Sharp or burning pain travelling from the neck into the shoulder, arm, or hand
- Numbness or tingling in specific fingers rather than the whole hand
- Weakness in a particular movement, lifting the arm, straightening the elbow, gripping
- Pain that worsens when looking up or turning the head toward the affected side
- Relief when resting the hand on top of the head, which takes tension off the root
Urgent
Come in promptly if weakness is getting worse, or if you notice clumsiness in both hands, changes in balance, or difficulty walking. That pattern suggests the spinal cord rather than a single nerve root.
How it is diagnosed
Examination maps strength, sensation, and reflexes against the territory of each root, and provocative maneuvers reproduce or relieve the symptoms. MRI confirms which root is compressed and by what. Nerve conduction studies are occasionally used when the picture could also be explained by a nerve problem further down the arm.
Non-surgical treatment
Most people improve without surgery. Early care may include activity modification, anti-inflammatory medication when safe, and targeted physical therapy. A selective nerve root injection can relieve symptoms and confirm the level. Time does a considerable amount of the work, and it is reasonable to give it that time when strength is intact.
When surgery is considered
Surgery is discussed when arm pain remains severe despite appropriate non-operative care, or when weakness in the affected muscle group is progressing. Options depend on where the compression sits and on the alignment of the neck, and may include decompression from the front or the back, with motion preservation where it applies.