Cervical Radiculopathy: How to Tell if You Have a Pinched Nerve in Your Neck

 Cervical Radiculopathy: How to Tell if You Have a Pinched Nerve in Your Neck

Pain can be so severe when a nerve is pinched in the neck's spinal column that other, less obvious but still important, signs are missed.

The spinal cord in the neck is linked to the arm nerves by pairs of spinal nerves. These spinal nerves, also called "roots" or "radicles," carry messages (electrical impulses) from the nerves in the arms to the brain about things like touch, pain, heat, and cold on different parts of the skin. The cervical roots also send messages (also electrical impulses) from the brain to the muscles through the nerves in the arms, which makes them contract.

When a cervical root is pinched, it can hurt, but it can also block nerve impulses coming in and going out, which can make patches of skin numb, muscles weak, or both. Cervical radiculopathy is the name of the syndrome that happens when the neck is pinched. The suffix "-pathy" implies injury or impairment, so radiculopathy means damage or impairment of a radicle (root).

The spinal cord connects to the arms' nerves by four pairs of cervical roots. These roots are called for the part of the spinal cord to which they are connected: C5, C6, C7, and C8, with the "C" standing for cervical. A pinch of any of these roots usually causes sharp, deep pain in the shoulder that keeps the person who has it busy. However, the shoulder pain is the least helpful or diagnostic part of the person's symptoms.

The pain often shoots into the arm on the side that hurts, and moving your head and neck in particular ways can make it worse or bring it back. The discomfort in the arm is not as strong as the pain in the shoulder, but the location of the pain is typically the most important part of figuring out which root is pinched. Also, the numbness or weakening pattern changes depending on which root is pinched. The patterns are nearly the same for everyone, and they are as follows:

When C5 is damaged, it can cause pain on the top of the shoulder and in the first fourth of the arm, which is also where numbness happens. Weakness means that the person can't lift their arm to the side to the level of their shoulder or higher. The doctor can't utilise good reflexes like a rubber hammer to evaluate this root.

When C6 is damaged, pain can go all the way to the thumb, which is also where numbness happens. When there is weakness, it means that the elbow can't bend. The doctor can also check for C6 impairment by hitting a tendon in the crook of the elbow with the biceps reflex.

C7 problems can cause pain that goes all the way to the middle fingers, which is also where numbness happens. When there is weakness, it means that the elbow can't be straightened. The doctor can also check for C7 damage by using the triceps reflex, which means hitting a tendon on the back of the elbow.

C8 impairment can cause pain that goes all the way to the little finger, which is also where numbness happens if it happens. When there is weakness, it affects some hand movements, like being able to touch the tips of the thumb and little finger together and spread the fingers out to the side. The doctor can't use any good reflexes to test this root.

After figuring out what the common syndromes are, the next step is to figure out what created the pinch in the first place. A herniated ("slipped") disc or a bony spur is usually what it is. Younger persons are more likely to have a herniated disc, while older adults are more likely to have a bony spur. Discs are soft structures that exist between each pair of vertebral bodies (spinal column bones). Their normally robust outer membranes can get weaker and let inner disc material leak out, like toothpaste coming out of a tube, into the side canals that the spinal roots have to go through. This holds them in place and squeezes them. Bony spurs, on the other hand, are not soft at all. They are actually strong ridges of extra bone that are found on the margins of the backbones. Arthritic degeneration makes them. They can also trap and crush the spinal roots as they leave the spine.

How do doctors figure out if you have cervical radiculopathy? As said, the patient's history and examination frequently yield significant and detailed information. When the pattern of nerve damage is unclear, tests that measure the electricity in nerves and muscles, including nerve conduction studies and electromyography, can assist find the problem. These electrical testing can also find problems with the nerves in the arms that may seem like cervical radiculopathy but need distinct medical care.

Myelograms were the best way to see the pinches in the spine until the 1980s. To do a myelogram, the doctor started by doing a lumbar puncture (also called a spinal tap) in the lower back of the patient. They then injected x-ray dye into the aqueous space inside the membrane that covers the spinal cord and its roots. Then, the subject was angled such that the dye flowed into the right region in the neck. Standard x-ray photographs showed the column of dye and any dents in the column that were caused by a herniated disc or bony spur.

Magnetic resonance imaging (MRI) was created in the 1980s and made similar pictures without the need for a spinal tap or dye infusion. Computed tomographic (CT) scans, which were invented in the 1970s, are usually the least useful of the spinal imaging procedures. However, they can be quite helpful if a myelogram was done right before them. None of these imaging tests are usually the best, thus testing must be tailored to each patient. Each test has its pros and cons.

What about treating this condition? That is a story that needs its own essay. Stay tuned.

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