What is a pinched nerve?
Cervical radiculopathy, also commonly referred to as a pinched nerve, is a spinal compression condition that occurs when a nerve located in the neck is compressed. The cervical nerves control the muscle function and feeling in the back of the head, neck, shoulders and upper parts of the back and chest.
Most people will experience a pinched nerve at some point in their life, but for some it can become a serious health condition. If treated early, you can typically avoid any long-term nerve damage. If the pressure is not relieved, you could sustain long-term or permanent nerve damage.
Causes of a pinched nerve
There are a variety of causes of cervical radiculopathy including:
- Arthritis — cervical radiculopathy can be caused by everyday wear and tear on the spine as people age.
- Spinal stenosis — spinal stenosis can cause cervical radiculopathy in patients over the age of 60.
- Injury — a pinched nerve in the neck can also occur after a sudden injury that causes a herniated disk.
- Repetitive work — repetitive work, such as in factory worker jobs, can put extra pressure on the cervical vertebrae and cause pinched nerves in the neck.
- Sports activities or hobbies — sports that require repetitive motions like swimming or tennis may cause cervical radiculopathy.
Risk factors for pinched nerve
Older age is the primary risk factor for a piched nerve, in addition to activities that repeatedly place a load on the spine in the neck, such as high-impact sports.
Symptoms of pinched nerve
Symptoms of a pinched nerve include:
- Pain in the arms, neck, chest, upper back and shoulders
- Weakness in the fingers and hands
- Numbness in arms, fingers or hands
- Loss of coordination in the hands or fingers
Diagnosis for pinched nerve
A pinched nerve can be diagnosed in a physical exam with your doctor. Your doctor will take a full medical history, evaluate your symptoms and perform a full physical exam.
During the medical history, your doctor will determine if you have any illness, conditions or recent activities or accidents that could have caused a nerve to be pinched. Your doctor may also perform a Spurling’s test, which allows the doctor to determine if by compressing the cervical spine, he or she can reproduce a patient’s symptoms.
Some patients may need more advanced diagnostic testing such as:
Magnetic resonance imaging (MRI)
An MRI scan is the most commonly used test to diagnose a pinched nerve. This test can determine if you have a herniated disc or bone spur that is pushing on a nerve in the neck.
An electrodiagnostic test, such as an electromyography, can determine how well the nerves are functioning. An electromyography is only used in severe cases when necessary.
Treatment for pinched nerve
Treatment for a pinched nerve will depend on the severity of your case and what is causing your symptoms. Most cases of cervical radiculopathy can be treated with medication and physical therapy. If your symptoms are not relieved with nonsurgical treatments, surgical intervention may be necessary.
Nonsurgical treatments for pinched nerve include:
Rest or activity modification
Some patients can relieve their symptoms with activity modification alone. If possible, avoid strenuous activities and lifting heavy objects when you first feel symptoms. If your symptoms relieve on their own, gradually work back into a routine.
Mercy Health physical therapists can develop a physical therapy plan that is most appropriate for your case. Physical therapy may involve specific exercises or stretches that may alleviate pain.
Anti-inflammatory medication is available to relieve symptoms of cervical radiculopathy. Over-the-counter options like ibuprofen or aspirin can be tried first, and if those are not strong enough, your doctor may prescribe muscle relaxants or prescription strength NSAIDs.
In some cases, patients are given steroid injections directly into the cervical spine.
When nonsurgical techniques are not effective, or symptoms are worsening, surgery may be necessary to treat cervical radiculopathy.
Surgical options include:
Anterior cervical discectomy and fusion
An anterior cervical discectomy and fusion is the most commonly performed surgery to treat cervical radiculopathy. This surgery is performed through a small incision in the front of the neck that removes a damaged or herniated disc. When the disc is removed, the spine is fused back together, but room is left for the spinal nerves to pass through.
Artificial disc replacement
During this procedure, your damaged or herniated disc is replaced with an artificial disc. The goal of this surgery is to maintain mobility in the spine.