What are the common signs and symptoms of cervical radiculopathy? How does the location of the affected nerve root impact the experience of tingling, numbness, pain, and weakness? Get the answers to these questions and more in this comprehensive guide.

Navigating Cervical Radiculopathy Symptoms

Cervical radiculopathy is a condition that occurs when a nerve root in the cervical spine becomes inflamed or damaged, resulting in a range of neurological deficits and often pain radiating down the arm and into the hand. Understanding the specific symptoms associated with cervical radiculopathy is crucial for accurate diagnosis and effective treatment.

Neurological Deficits in Cervical Radiculopathy

Cervical radiculopathy can manifest through various neurological deficits, including:

• Sensory changes: Feelings of numbness, reduced sensation, tingling, or electrical sensations in the affected areas.
• Motor impairments: Weakness or reduced coordination in one or more muscles.
• Reflex changes: Diminished or altered involuntary (automatic) reflex responses, such as reduced triceps or biceps reflex when the elbow is tapped.

The specific neurological deficits experienced depend on which nerve root is affected and whether the motor or sensory fibers are primarily impacted.

Patterns of Cervical Radiculopathy Symptoms

While cervical radiculopathy symptoms can vary widely from patient to patient, there are some common patterns that can be observed based on the affected nerve root:

C5 Radiculopathy

Symptoms of C5 radiculopathy may include tingling, numbness, and/or pain radiating from the neck into the shoulder and/or down the arm and into the thumb. Weakness may be experienced in the shoulder or upper arm.

C6 Radiculopathy

In C6 radiculopathy, tingling, numbness, and/or pain may radiate through the arm and into the index finger. Weakness may occur in the front of the upper arm (biceps) or in the wrist and hand.

C7 Radiculopathy

Symptoms of C7 radiculopathy often include tingling, numbness, and/or pain radiating down the arm and into the middle finger. Weakness may be experienced in the triceps or in the hand and fingers.

C8 Radiculopathy

C8 radiculopathy may result in tingling, numbness, and/or pain in the little finger and the inner aspect of the forearm. Weakness may be present in the hand and fingers, particularly the intrinsic hand muscles.

The Role of Pain in Cervical Radiculopathy

Cervical radiculopathy is often accompanied by some form of radicular pain, but this is not always the case. The pain experienced can range from a dull, general discomfort to a sharp, shock-like or burning sensation, and may be felt anywhere from the neck down to the fingers.

It is important to note that a radiculopathy and radicular pain are not the same thing. A radiculopathy involves a neurological deficit, while radicular pain can occur without a neurological deficit. Some patients with cervical radiculopathy may have little to no pain in the neck or arm, despite the presence of neurological deficits.

Diagnosing Cervical Radiculopathy

Accurately diagnosing cervical radiculopathy involves a comprehensive medical evaluation, including a thorough physical examination and potentially additional diagnostic tests, such as imaging studies or electrodiagnostic testing. By understanding the specific pattern of symptoms and their correlation with the affected nerve root, healthcare providers can develop an appropriate treatment plan.

Cervical Radiculopathy Treatment

The treatment for cervical radiculopathy often involves a combination of conservative and, in some cases, surgical interventions. Conservative treatments may include physical therapy, anti-inflammatory medications, and spinal injections, while surgical options may be considered for more severe or persistent cases. The specific treatment approach will depend on the individual patient’s symptoms, underlying cause, and response to initial management strategies.

By gaining a comprehensive understanding of the symptoms and patterns associated with cervical radiculopathy, individuals can work closely with their healthcare providers to develop an effective treatment plan and achieve optimal outcomes.

Cervical Radiculopathy Symptoms | Spine-health

Cervical radiculopathy signs and symptoms typically include pins-and-needles tingling, numbness, and/or weakness in the areas served by the affected nerve root. In addition to these neurological deficits, pain is also present in most cases. These signs and symptoms may be felt in one area only, such as the shoulder, or progress along the entire arm and into the hand and fingers.

Cervical radiculopathy is caused when a nerve root in the cervical spine becomes inflamed or damaged, resulting in neurological deficits (and commonly pain) radiating down the arm and/or hand. Read Understanding Hand Pain and Numbness

Cervical radiculopathy signs and symptoms are most commonly on just one side of the body, but they can be on both sides. If neurological deficits become severe or go into the hand, they can reduce the ability to perform many routine tasks, such as gripping or lifting objects, writing, typing, or getting dressed.

See What Causes Hand Pain and Numbness?

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Neurological Deficits in Cervical Radiculopathy

Cervical radiculopathy involves one or more of the following neurological deficits that may be experienced in the neck, shoulder, arm, hand, and/or fingers:

• Sensory. Feelings of numbness or reduced sensation in the skin. There may also be tingling, electrical sensations.
• Motor. Weakness or reduced coordination in one or more muscles.
• Reflex. Changes in the body’s involuntary (automatic) reflex responses. Some examples may include diminished ability to respond when the skin touches hot or cold, or possibly a reduced triceps or biceps reflex when the elbow is tapped by a rubber hammer during an exam.

See Could That Shoulder Pain Really Stem From the Neck?

Cervical nerve roots are comprised of both motor and sensory fibers. Whether cervical radiculopathy signs involve diminished motor movement or sensation (or both) depends on which fibers are damaged by the radiculopathy.

In This Article:

• What Is Cervical Radiculopathy?

• Cervical Radiculopathy Causes and Risk Factors

• Cervical Radiculopathy Symptoms

• Diagnosing Cervical Radiculopathy

• Cervical Radiculopathy Treatment

• Cervical Radiculopathy Interactive Video

• Treatment for Cervical Radiculopathy Video

How Pain May Feel with Cervical Radiculopathy

Cervical radiculopathy is typically accompanied by some form of radicular pain, but not always. In cases where cervical radiculopathy involves pain, it can range anywhere from a dull, general discomfort or achiness to a sharp, shock-like or burning pain. Cervical radicular pain may be felt anywhere from neck all the way down the arm into the fingers.

See Radiculopathy, Radiculitis and Radicular Pain

While a radiculopathy is commonly accompanied by radicular pain, the two are not the same. A radiculopathy involves a neurological deficit, whereas radicular pain can occur without a neurological deficit. It is possible to have cervical radiculopathy with little to no pain in the neck and/or arm, but most cases do involve pain in addition to the neurological deficits.

Cervical radiculopathy signs and symptoms differ depending on which nerve root is affected. For example, C6 radiculopathy occurs when the nerve root that runs above the C6 vertebra is affected.

See Cervical Spinal Nerves

While any patient’s specific signs and symptoms can vary widely and do not always follow a predictable pattern,

¹
McAnany SJ, Rhee JM, Baird EO, et al. Observed patterns of cervical radiculopathy: how often do they differ from a standard, "Netter diagram" distribution? Spine J. 2018. pii: S1529-9430(18)31090-8.
the following are common descriptions for how cervical radiculopathy may differ by location:

The location of cervical radiculopathy symptoms will vary depending on which nerve root is affected.

• C5 radiculopathy. Tingling, numbness, and/or pain may go from the neck into the shoulder and/or down the arm and into the thumb. Weakness may be experienced in the shoulder or upper arm.
• C6 radiculopathy. Tingling, numbness, and/or pain may radiate through the arm and into the second digit (index finger). Weakness may occur in the front of the upper arm (biceps) or wrist.

  See All About the C5-C6 Spinal Motion Segment

• C7 radiculopathy. Tingling, numbness, and/or pain may be felt down the arm and into the middle finger. Weakness may be experienced in the back of the upper arm (triceps).

  Watch Spinal Motion Segment: C6-C7 Animation

• C8 radiculopathy. Tingling, numbness, and/or pain may radiate down the arm and into the little finger. Handgrip strength may be reduced.

  See All About the C7-T1 Spinal Segment (Cervicothoracic Junction)

Less commonly, cervical radiculopathy can occur higher in the cervical spine, such as C4 radiculopathy or higher. While rare, it is also possible to have nerve compression or inflammation at multiple levels of the cervical spine at the same time, resulting in multiple radiculopathies.

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Sometimes cervical radiculopathy signs and symptoms flare up with certain activities, such as bending the neck forward to peer at a mobile phone or laptop screen for long periods, and will resolve when the neck is supported and at rest. For others, signs and symptoms may become persistent and do not resolve when the neck is in a supported, resting position.

Dr. Zinovy Meyler is a physiatrist with over a decade of experience specializing in the non-surgical care of spine, muscle, and chronic pain conditions. He is the Co-Director of the Interventional Spine Program at the Princeton Spine and Joint Center.

• 1
  McAnany SJ, Rhee JM, Baird EO, et al. Observed patterns of cervical radiculopathy: how often do they differ from a standard, “Netter diagram” distribution? Spine J. 2018. pii: S1529-9430(18)31090-8.

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Cervical Herniated Disc Signs and Symptoms

When a cervical disc herniates, its soft inner material and inflammatory proteins start to leak into the protective outer layer and possibly into the spinal column. A herniated disc commonly causes a sharp or shock-like pain in the neck and/or arm by inflaming or compressing a nearby nerve root. Other nearby structures, such as the spinal cord, may also become inflamed and painful.

Watch: Cervical Spine Anatomy Video

A cervical herniated disc can cause pain that radiates throughout the neck, shoulders, arms, and hands. Watch: Cervical Radiculopathy Interactive Video

Some common signs and symptoms of a cervical herniated disc include:

• Neck pain. This pain is typically felt toward the back or side of the neck. It can range from a mild pain that feels tender when touched to a sharp or burning pain.

  See All About Neck Pain

• Radicular pain. This pain can radiate from a pinched nerve in the neck down through the shoulder, arm, hand, and/or fingers. It can sometimes feel hot or electric shock-like.

  See Radiculopathy, Radiculitis and Radicular Pain

• Cervical radiculopathy. A pinched nerve or nerve root inflammation may also cause numbness and/or weakness to radiate down into the shoulder, arm, hand, and/or fingers. Radicular pain may also accompany radiculopathy in some instances.

  See Cervical Radiculopathy from a Herniated Cervical Disc

• Symptoms worsen with specific head positions or activities. A herniated disc’s pain tends to flare-up and feel worse during activities, such while playing a sport or lifting a heavy weight. Certain head positions—such as twisting to one side or tilting the head forward—may also worsen the pain.
• Neck stiffness. Pain and inflammation from a cervical herniated disc may restrict certain neck movements and reduce range of motion.

  See Stiff Neck Causes, Symptoms, and Treatment

The specific pain patterns and neurological deficits are largely determined by the location of the herniated disc.

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Typical pain areas for cervical disc herniation. Symptoms vary depending on which nerve root is compressed.

The cervical spine contains 7 vertebrae stacked atop each other, labeled C1 down to C7. The intervertebral discs are located between adjacent vertebral bodies. For example, the C5-C6 disc sits between the C5 and C6 vertebrae. If the C5-C6 disc herniates, it can compress a C6 nerve root. The signs and symptoms caused by a cervical herniated disc can vary depending on which nerve root is compressed. For example:

• C4-C5 (C5 nerve root): Pain, tingling, and/or numbness may radiate into the shoulder. Weakness may also be felt in the shoulder (deltoid muscle) and other muscles.

  See All About the C2-C5 Spinal Motion Segments

• C5-C6 (C6 nerve root): Pain, tingling, and/or numbness may be felt in the thumb side of the hand. Weakness may also be experienced in the biceps (muscles in the front of the upper arms) and wrist extensor muscles in the forearms. The C5-C6 disc is one of the most common to herniate.

  ¹
  Rainville J, et al. Comparison of symptoms from C6 and C7 radiculopathy. Spine (Phila Pa 1976). 2017; 42(20):1545-51. doi: 10.1097/BRS.0000000000002353.

  See C5-C6 Treatment

• C6-C7 (C7 nerve root): Pain, tingling, and/or numbness may radiate into the hand and middle finger. Weakness may also be felt in the triceps (muscles in the back of the upper arm), finger extensors, and other muscles. The C6-C7 disc is commonly considered the most likely to herniate in the cervical spine.

  ¹
  Rainville J, et al. Comparison of symptoms from C6 and C7 radiculopathy. Spine (Phila Pa 1976). 2017; 42(20):1545-51. doi: 10.1097/BRS.0000000000002353.

  See All About the C6-C7 Spinal Motion Segment

• C7-T1 (C8 nerve root): Pain, tingling, and/or numbness may be felt in the outer forearm and pinky side of the hand. Weakness may also be experienced in finger flexors (handgrip) and other muscles.

  See All About the C7-T1 Spinal Segment (Cervicothoracic Junction)

These are typical pain patterns associated with a cervical disc herniation, but they are not absolute. Some people are simply wired differently than others, and therefore their arm pain and other symptoms will be different.

In This Article:

• Cervical Herniated Disc Symptoms and Treatment Options

• Cervical Herniated Disc Signs and Symptoms

• Cervical Herniated Disc Causes and Diagnosis

• Conservative Treatment for a Cervical Herniated Disc

• Spine Surgery for a Cervical Herniated Disc

• Cervical Herniated Disc Video

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If the spinal cord becomes compressed or inflamed by a cervical herniated disc, signs and symptoms may include:

• Pain, tingling, numbness, and/or weakness in both arms and/or both legs
• Problems with coordination or walking
• Difficulty with bladder and/or bowel control

Any of these signs or symptoms require immediate medical attention.