C6 Dermatome Tingling: Understanding Cervical Radiculopathy Symptoms and Treatment

26.07.202306.07.2023 by alexxlab

What are the symptoms of C6 dermatome tingling. How is cervical radiculopathy diagnosed. What treatment options are available for cervical radiculopathy. What are the causes and risk factors of cervical radiculopathy. How can cervical radiculopathy impact daily life.

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What is Cervical Radiculopathy and Its Common Symptoms?

Cervical radiculopathy occurs when a nerve root in the cervical spine becomes inflamed or damaged, leading to neurological deficits and often pain that radiates down the arm and into the hand. The symptoms typically include:

Pins-and-needles tingling sensation
Numbness in affected areas
Weakness in muscles served by the affected nerve root
Pain ranging from dull discomfort to sharp, shock-like sensations

These symptoms may be localized to one area, such as the shoulder, or progress along the entire arm and into the hand and fingers. In most cases, cervical radiculopathy affects only one side of the body, but it can occasionally occur bilaterally.

How does cervical radiculopathy impact daily activities?

When neurological deficits become severe or extend into the hand, they can significantly impair a person’s ability to perform routine tasks. Some activities that may become challenging include:

Gripping or lifting objects
Writing or typing
Getting dressed
Performing fine motor tasks

Understanding the Neurological Deficits in Cervical Radiculopathy

Cervical radiculopathy involves one or more of the following neurological deficits that may be experienced in various parts of the upper body:

Sensory deficits: Numbness, reduced sensation, or tingling in the skin
Motor deficits: Weakness or reduced coordination in one or more muscles
Reflex changes: Alterations in the body’s involuntary responses, such as diminished ability to react to temperature changes or reduced reflexes in the triceps or biceps

The specific symptoms experienced depend on which nerve fibers (motor or sensory) are affected by the radiculopathy. It’s important to note that while radiculopathy often involves pain, it is primarily defined by these neurological deficits.

Can cervical radiculopathy occur without pain?

Yes, it is possible to have cervical radiculopathy with little to no pain in the neck or arm. However, most cases do involve some form of pain in addition to the neurological deficits. The pain can range from a dull ache to a sharp, burning sensation and may be felt anywhere from the neck down to the fingers.

Identifying Specific Nerve Root Involvement in Cervical Radiculopathy

The symptoms of cervical radiculopathy differ depending on which nerve root is affected. While individual cases can vary, here are some common patterns:

What are the typical symptoms of C5 radiculopathy?

C5 radiculopathy often presents with:

Tingling, numbness, or pain from the neck into the shoulder and possibly down the arm to the thumb
Weakness in the shoulder or upper arm muscles

How does C6 radiculopathy typically manifest?

C6 radiculopathy symptoms may include:

Tingling, numbness, or pain radiating through the arm and into the index finger
Weakness in the biceps or wrist extensor muscles

Causes and Risk Factors of Cervical Radiculopathy

Cervical radiculopathy can be caused by various factors that compress or irritate the nerve roots in the cervical spine. Some common causes include:

Herniated or bulging discs
Degenerative disc disease
Bone spurs (osteophytes) from cervical osteoarthritis
Spinal stenosis
Traumatic injury to the cervical spine

Several risk factors may increase the likelihood of developing cervical radiculopathy:

Age: The condition is more common in middle-aged and older adults
Occupation: Jobs involving repetitive neck motions or prolonged awkward positioning
Genetics: Family history of degenerative spine conditions
Smoking: Can accelerate disc degeneration
Previous neck injuries

How does age contribute to the development of cervical radiculopathy?

As we age, the structures in our spine naturally degenerate. This process can lead to disc herniation, bone spur formation, and narrowing of the spinal canal, all of which can contribute to nerve root compression and subsequent radiculopathy. The peak incidence of cervical radiculopathy occurs between the ages of 50 and 54.

Diagnostic Approaches for Cervical Radiculopathy

Diagnosing cervical radiculopathy typically involves a combination of clinical examination and imaging studies. The process may include:

Medical history review
Physical examination
Neurological assessment
Imaging studies (X-rays, MRI, CT scans)
Electromyography (EMG) and nerve conduction studies

What does the physical examination for cervical radiculopathy entail?

During the physical exam, a healthcare provider may:

Assess range of motion in the neck
Check for muscle weakness or atrophy
Test sensory responses in the arms and hands
Perform specific provocative tests, such as the Spurling’s test
Evaluate reflexes in the upper extremities

These assessments help identify the affected nerve root and rule out other potential causes of symptoms.

Treatment Options for Cervical Radiculopathy

The treatment of cervical radiculopathy aims to relieve pain, improve function, and prevent further nerve damage. Treatment options can be broadly categorized into conservative and surgical approaches:

What are the common conservative treatments for cervical radiculopathy?

Conservative treatments, which are often the first line of defense, may include:

Rest and activity modification
Physical therapy and exercise
Medications (NSAIDs, muscle relaxants, oral corticosteroids)
Cervical traction
Cervical epidural steroid injections
Chiropractic care
Acupuncture

When is surgery considered for cervical radiculopathy?

Surgery may be recommended if:

Conservative treatments fail to provide relief after 6-12 weeks
There is progressive neurological deficit
Severe pain persists despite conservative management
There is evidence of spinal cord compression

Surgical options may include anterior cervical discectomy and fusion (ACDF), artificial disc replacement, or posterior cervical foraminotomy.

Lifestyle Modifications and Self-Care for Managing Cervical Radiculopathy

In addition to medical treatments, certain lifestyle changes and self-care strategies can help manage cervical radiculopathy symptoms:

Maintaining proper posture
Using ergonomic workstations
Practicing stress-reduction techniques
Applying heat or ice therapy
Performing gentle neck stretches and exercises as recommended by a healthcare provider
Getting adequate sleep and rest
Avoiding activities that exacerbate symptoms

How can ergonomic adjustments help alleviate cervical radiculopathy symptoms?

Ergonomic adjustments can significantly reduce strain on the neck and upper back, potentially alleviating cervical radiculopathy symptoms. Some helpful modifications include:

Adjusting computer monitors to eye level
Using a headset for phone calls
Ensuring proper chair height and lumbar support
Taking regular breaks to stretch and move
Using a standing desk for part of the workday

Long-Term Prognosis and Prevention of Cervical Radiculopathy

The long-term outlook for cervical radiculopathy is generally favorable, with many patients experiencing significant improvement with conservative treatment. However, some individuals may have recurring symptoms or require ongoing management.

What strategies can help prevent cervical radiculopathy?

While not all cases of cervical radiculopathy can be prevented, certain measures may reduce the risk:

Maintaining a healthy weight
Exercising regularly, focusing on neck and core strengthening
Practicing good posture
Avoiding smoking
Using proper lifting techniques
Taking breaks during prolonged periods of desk work or driving
Managing stress through relaxation techniques

By implementing these preventive strategies and seeking prompt medical attention for neck pain or neurological symptoms, individuals can potentially reduce their risk of developing cervical radiculopathy or experiencing recurrent episodes.

Understanding cervical radiculopathy, its symptoms, and treatment options is crucial for anyone experiencing neck pain or related neurological deficits. While the condition can be uncomfortable and sometimes debilitating, with proper diagnosis and management, most individuals can find relief and maintain their quality of life. If you suspect you may have cervical radiculopathy, consult with a healthcare professional for a thorough evaluation and personalized treatment plan.

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.