Cervical neuropathy, which is also known as cervical radiculopathy, is a term used to describe the signs and symptoms caused by compression of one of the nerves originating from your spinal cord in your neck. The nerves that arise from your cervical spine supply the back of your head, your neck, your shoulders and upper extremities and the upper portions of your back and chest. Since your cervical nerves control both sensation and muscle function in these areas, cervical neuropathy can manifest in a variety of ways.
According to experts at New York’s Hospital for Special Surgery, the most common symptoms of cervical radiculopathy are pain and unusual sensations -- numbness, cold, warmth or tingling -- in your upper extremity in the area served by the injured nerve. Depending on the nerve or nerves that are involved, you might also have headaches or neck pain. The discomfort associated with cervical radiculopathy can be disabling, and patients often miss work and are unable to fulfill social obligations.
Loss of Function
Although pain and paresthesias -- abnormal sensations -- are the most common and usually the earliest symptoms of cervical radiculopathy, compression or injury of a cervical nerve may also lead to functional deficits. Weakness of the shoulder, bicep, tricep, forearm or hand muscles is not unusual in people who have cervical radiculopathy. The reflexes in your biceps or triceps muscles may also be reduced or absent, but this is a sign that might only be detectable during a detailed medical evaluation.
Your neck is composed of a series of stacked vertebra that are separated by tough, fibrous cushions called discs. Because your neck is highly mobile, the intervertebral discs and the joints between your vertebrae are subject to wear and injury. Arthritis in your neck or a bulging disc can impinge on one of the nerves emerging from your cervical spinal cord and trigger cervical radiculopathy symptoms. Such degenerative changes are the most common cause of cervical radiculopathy. According to a 2010 review in the “Journal of Korean Neurosurgical Society,” approximately three-fourths of degenerative cervical radiculopathies arise from arthritis, while the remaining 25 percent are due to disc herniations. However, bulging discs and neck arthritis often coexist, so it may be difficult to assign your symptoms to only one cause.nOther potential causes of cervical radiculopathy include trauma, instability due to rheumatoid arthritis or other chronic diseases or, rarely, tumors.
Diagnosis and Treatment
A number of methods are used to diagnose the cause of cervical radiculopathy, including plain x-rays, CT, magnetic resonance imaging and electrical studies to measure nerve and muscle function. Physical examination is important for determining the severity of weakness due to nerve compression. Studies show that 75 to 90 percent of patients with cervical radiculopathy will improve with conservative management, which includes oral painkillers, muscle relaxants, antiinflammatory medications, neck traction and physical therapy. Injection of steroids into the area around the affected cervical nerve is also an effective treatment for many patients. Surgery is reserved for people with persistent symptoms or severe neurologic deficits, such as profound weakness in the involved arm.
A Word on Manipulation
Many people with back or neck problems seek relief at the hands of a chiropractor. Currently, there is insufficient evidence to support the use of chiropractic manipulation for treating cervical radiculopathy. A 2012 review in “The Journal of the Canadian Chiropractic Association” suggested that the Neck Disability Index -- a questionnaire designed to categorize the symptoms of patients with neck pain -- could guide chiropractic manipulation for patients with cervical radiculopathy. However, most experts advise against manipulation for this condition. If you have pain or numbness in your neck or arm, see your physician for an evaluation.