A Real Pain In The Neck

A Real Pain In The Neck



It seems logical that when we feel pain somewhere in our body, it is because something is not right in that same area. For example, you smash your finger with a hammer, it is your finger that hurts, not your foot.  However, there are some physical maladies that do not follow that logical conclusion and can be a bit perplexing.  Cervical radiculopathy is one such condition.

Cervical radiculopathy is often referred to as a pinched nerve in the neck. It is characterized by radiating pain from the neck to the shoulder, shoulder blade, arm, or hand. Weakness and lack of coordination in the arm and hand can also occur. The condition affects an average of 85 out of 100,000 people—most often individuals in their 50’s. Athletes, heavy laborers, and workers who use vibrating machinery are commonly affected. People who sit for long periods of time, or individuals with arthritis in the cervical (neck) region can also be affected.

Cervical radiculopathy occurs when a nerve root coming off the spinal cord becomes compressed. The compression can occur for various reasons. In younger people, it may occur when a cervical disc herniates due to trauma. In older individuals, it commonly occurs seemingly out of nowhere but is a result of arthritis or decreased disc height in the neck region.

The cervical spine consists of 7 cervical vertebrae (the bones that form the neck region). Each vertebra is separated by a gel-like disc. The discs provide shock absorption for the spine. The spinal cord travels through a canal in the cervical vertebrae. Spinal nerve roots extend from the spinal cord and branch off going to specific locations in the arm. The spinal nerves send signals to our muscles for movement as well as sensations that we feel in the entire arm. The spinal cord is like a tree trunk, and the spinal nerves are like the tree branches. If an impingement or abnormal pressure is placed on a branch near the trunk, everything along that branch will be affected.

When the spinal nerves are impinged, they cannot properly send messages to the muscles from the brain, nor receive proper sensation from the specific arm location the nerve travels. Everywhere the spinal nerve travels will be affected. That is why a pinched nerve in the neck can cause pain, weakness, and loss of sensation in the arm or hand.

Symptoms of cervical radiculopathy vary depending on the nerve root involved, and commonly occur on the same side of the body as the affected nerve. The symptoms may include:

  • Pain in the neck, shoulder blade, shoulder, upper chest, or arm, with pain possibly radiating into the fingers following the path of the involved nerve root.
  • Pain described as “sharp” or “pins-and-needles” or “popping sensation” in cervical region.
  • General dull ache or numbness anywhere along the pathway of the nerve.
  • Weakness in the shoulder, arm, or hand.
  • Pain that worsens with certain neck movements.
  • Pain that improves when the arm is lifted over and behind the head (relieving tension on the spinal nerve).

These symptoms may also be specific to the nerve root involved. The most common nerve root levels for this condition are C6 and C7.

Most cases are best treated conservatively. If you feel you may have this condition, consult your doctor. Often they will refer you to a physical therapist. In physical therapy we use treatments such as hot and cold packs, electrical stimulation to calm the nerve pain and manual therapy techniques such as cervical traction to relieve the pressure in the neck region. We also focus on gentle stretching and strengthening exercises as well as postural education and a home exercise program to reduce neck stress and fatigue and prevent re-occurrence.

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