C6 Dermatome Tingling: Understanding Cervical Radiculopathy Symptoms

28.07.202306.07.2023 by alexxlab

What are the symptoms of cervical radiculopathy. How does C6 dermatome tingling differ from other cervical nerve root issues. What causes cervical radiculopathy and who is at risk. How is cervical radiculopathy diagnosed and treated.

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What is Cervical Radiculopathy?

Cervical radiculopathy occurs when a nerve root in the cervical spine (neck) becomes inflamed or damaged. This condition results in neurological symptoms that radiate along the path of the affected nerve, typically down the arm and into the hand. The hallmark signs of cervical radiculopathy include:

Tingling or pins-and-needles sensations
Numbness
Weakness in areas served by the affected nerve
Pain (in most cases)

These symptoms may be localized to one area, such as the shoulder, or extend along the entire arm into the hand and fingers. While cervical radiculopathy commonly affects only one side of the body, it can occur bilaterally in some cases.

Understanding the Neurological Deficits of Cervical Radiculopathy

The neurological deficits associated with cervical radiculopathy can be categorized into three main types:

1. Sensory Deficits

Sensory deficits involve changes in skin sensation, which may include:

Numbness
Reduced sensation
Tingling
Electrical sensations

2. Motor Deficits

Motor deficits affect muscle function and may present as:

Weakness in one or more muscles
Reduced coordination

3. Reflex Changes

Reflex changes involve alterations in the body’s involuntary responses, such as:

Diminished ability to respond to hot or cold stimuli
Reduced triceps or biceps reflex

Do all cases of cervical radiculopathy involve both motor and sensory symptoms? Not necessarily. The specific symptoms experienced depend on which nerve fibers (motor, sensory, or both) are affected by the radiculopathy.

The Role of Pain in Cervical Radiculopathy

While neurological deficits are the defining feature of cervical radiculopathy, pain is also a common companion to this condition. Cervical radicular pain can vary widely in its presentation:

It may range from a dull ache to a sharp, shock-like sensation
The pain can be felt anywhere from the neck down to the fingertips
Some patients may experience little to no pain, focusing primarily on the neurological symptoms

Is radicular pain the same as radiculopathy? No, these terms are not interchangeable. Radiculopathy specifically refers to the neurological deficit, while radicular pain describes the pain that often accompanies it. It’s possible to have radicular pain without radiculopathy, and vice versa.

C6 Dermatome Tingling: A Closer Look at C6 Radiculopathy

C6 radiculopathy occurs when the nerve root that exits above the C6 vertebra is affected. This specific type of cervical radiculopathy has some characteristic symptoms:

Tingling, numbness, and/or pain may radiate through the arm and into the index finger
Weakness may occur in the biceps or wrist extensors
Reduced biceps reflex may be observed

How does C6 radiculopathy differ from other cervical nerve root issues? Each cervical nerve root corresponds to a specific dermatome (area of skin) and myotome (group of muscles). For instance:

C5 radiculopathy often affects the shoulder and thumb
C7 radiculopathy typically involves the middle finger and triceps
C8 radiculopathy usually impacts the pinky finger and hand muscles

Understanding these patterns can help in diagnosing and differentiating between various types of cervical radiculopathy.

Causes and Risk Factors for Cervical Radiculopathy

Cervical radiculopathy can result from various underlying conditions that compress or irritate the cervical nerve roots. Some common causes include:

Herniated disc: When the soft inner material of a spinal disc protrudes and presses on a nerve root
Cervical spondylosis: Age-related degenerative changes in the cervical spine
Foraminal stenosis: Narrowing of the space where nerve roots exit the spinal canal
Trauma: Injuries that directly impact the nerve roots or surrounding structures

Who is at higher risk for developing cervical radiculopathy? Several factors can increase an individual’s susceptibility:

Age: The condition is more common in middle-aged and older adults
Occupation: Jobs involving repetitive neck movements or prolonged awkward positions
Genetics: Some individuals may have a hereditary predisposition
Smoking: This habit can accelerate disc degeneration
Previous neck injuries: These can make the cervical spine more vulnerable to future problems

Diagnosing Cervical Radiculopathy: A Comprehensive Approach

Accurate diagnosis of cervical radiculopathy is crucial for effective treatment. The diagnostic process typically involves several steps:

1. Medical History and Physical Examination

The healthcare provider will gather information about the patient’s symptoms, medical history, and perform a physical examination. This may include:

Assessing range of motion in the neck
Testing muscle strength and reflexes
Evaluating sensation in the affected areas
Performing specific tests like the Spurling’s test

2. Imaging Studies

Various imaging techniques can help visualize the cervical spine and identify potential causes of nerve root compression:

X-rays: To assess bone alignment and detect arthritic changes
MRI (Magnetic Resonance Imaging): Provides detailed images of soft tissues, including nerves and discs
CT (Computed Tomography) scan: Offers detailed bone imaging and can be useful when MRI is contraindicated

3. Electrodiagnostic Studies

These tests can help confirm the diagnosis and determine the severity of nerve involvement:

Electromyography (EMG): Assesses muscle function and can detect nerve root compression
Nerve Conduction Studies (NCS): Measure how well nerves transmit electrical signals

How do these diagnostic tools work together to provide a comprehensive picture? Each test offers unique information, and when combined, they allow healthcare providers to make an accurate diagnosis and develop an appropriate treatment plan.

Treatment Options for Cervical Radiculopathy

The treatment of cervical radiculopathy aims to relieve pain, improve function, and prevent further nerve damage. The approach typically starts with conservative measures and may progress to more invasive options if necessary.

1. Conservative Treatment

Initial management often includes:

Rest and activity modification
Physical therapy to improve neck strength and flexibility
Pain medications (NSAIDs, muscle relaxants)
Cervical traction
Cervical collar (for short-term use)

2. Interventional Procedures

If conservative measures don’t provide adequate relief, interventional procedures may be considered:

Epidural steroid injections
Selective nerve root blocks
Radiofrequency ablation

3. Surgical Intervention

Surgery may be recommended in cases of severe or persistent symptoms, or when there’s evidence of progressive neurological deficit. Surgical options include:

Anterior cervical discectomy and fusion (ACDF)
Cervical artificial disc replacement
Posterior cervical foraminotomy

What factors determine the choice of treatment? The selection of treatment depends on various factors, including the severity of symptoms, the underlying cause, the patient’s overall health, and their personal preferences.

Living with Cervical Radiculopathy: Long-term Management and Prognosis

While acute episodes of cervical radiculopathy can be challenging, many patients experience good outcomes with appropriate treatment. Long-term management strategies often include:

Maintaining good posture and ergonomics
Regular exercise to strengthen neck and shoulder muscles
Stress management techniques
Periodic follow-ups with healthcare providers

What is the typical prognosis for cervical radiculopathy? Many patients experience significant improvement within 4-6 months with conservative treatment. However, some may have persistent or recurrent symptoms that require ongoing management.

Can cervical radiculopathy be prevented? While it’s not always possible to prevent cervical radiculopathy, certain measures can reduce the risk:

Maintaining a healthy weight
Practicing good posture
Using proper lifting techniques
Taking regular breaks during prolonged desk work or repetitive activities
Quitting smoking

Emerging Treatments and Future Directions in Cervical Radiculopathy Management

As our understanding of cervical radiculopathy evolves, new treatment approaches are being explored:

1. Regenerative Medicine

Stem cell therapy and platelet-rich plasma (PRP) injections are being investigated for their potential to promote healing and reduce inflammation in cervical radiculopathy.

2. Advanced Imaging Techniques

High-resolution MRI and dynamic imaging methods may improve diagnostic accuracy and guide more precise treatments.

3. Minimally Invasive Surgical Techniques

Endoscopic and robotic-assisted procedures are being developed to reduce surgical trauma and improve recovery times.

4. Neuromodulation

Techniques like spinal cord stimulation and peripheral nerve stimulation may offer new options for managing chronic radicular pain.

How might these emerging treatments change the landscape of cervical radiculopathy management? While many of these approaches are still in the research phase, they hold promise for providing more targeted, effective, and less invasive treatment options in the future.

As research continues, our understanding of cervical radiculopathy and its optimal management strategies will undoubtedly evolve. Patients experiencing symptoms of cervical radiculopathy, including C6 dermatome tingling, should work closely with their healthcare providers to develop a personalized treatment plan that addresses their specific needs and goals.

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?

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.

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.

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.

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.