What is cervical radiculopathy. How does it cause tingling, numbness and weakness in the arm and hand. What are the common symptoms and which nerve roots are typically affected.

Understanding Cervical Radiculopathy

Cervical radiculopathy is a condition that arises when a nerve root in the cervical spine becomes inflamed or damaged, leading to a variety of neurological deficits and often accompanied by pain. This condition can manifest in various ways, including tingling, numbness, and weakness in the affected areas of the body.

Causes and Risk Factors of Cervical Radiculopathy

Cervical radiculopathy can be caused by a variety of factors, including herniated discs, bone spurs, and degenerative changes in the spine. Factors that may increase the risk of developing this condition include age, genetics, and certain physical activities or occupations that put repeated stress on the neck.

Symptoms of Cervical Radiculopathy

The primary symptoms of cervical radiculopathy include sensory deficits, such as numbness or tingling, as well as motor deficits, such as weakness or reduced coordination in the affected muscles. These symptoms typically occur on one side of the body, but can sometimes affect both sides. The specific symptoms experienced by a patient will depend on which nerve root is affected.

Diagnosing Cervical Radiculopathy

Diagnosing cervical radiculopathy typically involves a combination of medical history, physical examination, and diagnostic tests, such as imaging studies or electrodiagnostic tests. These tests help to identify the underlying cause of the condition and guide the appropriate treatment approach.

Treatment for Cervical Radiculopathy

Treatment for cervical radiculopathy can involve a variety of conservative and surgical options, depending on the severity of the condition and the individual patient’s needs. Conservative treatments, such as physical therapy, medication, and spinal injections, may be effective in managing mild to moderate cases. In more severe cases, surgery may be necessary to address the underlying cause of the condition.

Cervical Radiculopathy Interaction Video

For a more interactive understanding of cervical radiculopathy, please refer to the accompanying video, which provides a detailed exploration of the condition and its various symptoms and treatment approaches.

Treatment for Cervical Radiculopathy Video

In addition to the interactive video, we have also included a separate video that focuses specifically on the treatment options for cervical radiculopathy, including both conservative and surgical approaches.

How does cervical radiculopathy cause tingling, numbness, and weakness in the arm and hand? Cervical radiculopathy occurs when a nerve root in the cervical spine becomes inflamed or damaged, leading to neurological deficits in the affected areas. These deficits can include sensory changes, such as tingling or numbness, as well as motor changes, such as weakness or reduced coordination. The specific symptoms experienced by a patient will depend on which nerve root is affected.

What are the common symptoms of cervical radiculopathy? The common symptoms of cervical radiculopathy include:
– Sensory deficits, such as numbness or tingling, in the affected areas
– Motor deficits, such as weakness or reduced coordination, in the affected muscles
– Pain, which can range from a dull ache to a sharp, burning sensation, radiating from the neck down the arm and into the hand or fingers
– Changes in reflexes, such as a diminished response when the skin is touched or the elbow is tapped

Which nerve roots are typically affected in cervical radiculopathy? The specific nerve roots affected in cervical radiculopathy can vary, but some of the more common patterns include:
– C5 radiculopathy: Symptoms may affect the shoulder, upper arm, and thumb
– C6 radiculopathy: Symptoms may affect the arm, second digit (index finger), and biceps muscle
– C7 radiculopathy: Symptoms may affect the arm, third digit (middle finger), and triceps muscle

How is cervical radiculopathy diagnosed? Diagnosing cervical radiculopathy typically involves a combination of medical history, physical examination, and diagnostic tests, such as:
– Imaging studies, like MRI or CT scans, to identify the underlying cause of the condition
– Electrodiagnostic tests, such as electromyography (EMG) or nerve conduction studies, to assess the function of the affected nerves
– Neurological examination to evaluate the patient’s sensory, motor, and reflex function

What are the treatment options for cervical radiculopathy? Treatment for cervical radiculopathy can involve both conservative and surgical approaches, depending on the severity of the condition and the individual patient’s needs. Conservative treatments may include:
– Physical therapy to strengthen and stabilize the affected area
– Medications, such as anti-inflammatory drugs or pain relievers, to manage symptoms
– Spinal injections, like epidural steroid injections, to reduce inflammation
In more severe cases, surgery may be necessary to address the underlying cause of the condition, such as a herniated disc or bone spur.

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.