Pinched Nerve In The Neck (Cervical Radiculopathy) - Non-surgical Treatment
By Dr. Amod Manocha in Pain Management
Feb 03 , 2022 | 3 min read
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What is Cervical Radiculopathy?
Cervical radiculopathy or pinched nerve in the neck is a common problem, where irritation of the nerves coming out of the spine can cause pain travelling to the shoulders and arms. The arm pain is often more severe although the root cause of the problem is in the neck. Pain may be accompanied by other symptoms such as pain tingling, numbness, weakness in the arm and hand.
The neck or the cervical region consists of seven bones called vertebrae stacked one above the other. Each vertebra encloses a hollow space which houses a thick bundle of nerves called the spinal cord. A pair of spinal nerves exits between every two vertebrae and supply a specific part of the body. When these nerves are irritated, it leads to the pain being felt not only in the neck but also in the area supplied by the nerve.
What are the causes of Cervical Radiculopathy?
This condition is seen more commonly in middle-ages and the common causes include
- Disc problems such as bulging of discs or slipped disc
- Age related wear and tear of spine leading to the narrowing of the exit spaces from where the nerves leave the spine
- Neck Instability and loss of alignment
Other less common causes include fractures, infection and tumours.
What are the symptoms of a pinched nerve in the neck?
Pain from a pinched nerve may be felt in one or both arms and may be accompanied by cervical pain. It can be of different types such as burning, sharp, squeezing, aching or electric shock like sensation. Often neck movements such as looking upwards or on turning the head towards one side can cause an increase in pain. Other symptoms include:
- Tingling or pins and needles sensation in the arm or hand
- Numbness or loss of feeling in arm or hand
- Shoulder, arm or hand weakness
How is Cervical Radiculopathy diagnosed?
MRI scans are the most useful investigation to confirm the diagnosis and assess severity as these provide detailed imaging of the spine including that of nerves and discs. In some cases investigations such as Nerve conduction velocity (NCV), Electromyography (EMG), x-rays and CT scans are also required.
When should one see a pain specialist?
It’s important to seek medical attention if the pain is
- Severe or persisting
- Impacting on your daily routine and quality of life
- Not responding to pain killers or reoccurring on stopping pain killers
- Associated with weakness, numbness in arms and hands, grip or gait abnormalities
- Associated with fever, weight loss
- First observed after trauma/ injury
- Present in individuals with other coexisting severe medical problems such as those with cancer, on immunosuppressant medicines, or on prolonged steroid
What are the treatment options for Cervical Radiculopathy?
Most individuals with cervical radiculopathy get significantly better within 3-6 months, although for some it can persist and transforms into chronic pain. Prompt diagnosis and timely treatment can reduce pain and restore functional ability.
Treatment entails a multimodal approach with a combination of lifestyle changes, medications, physical therapy and injections, used to obtain maximal relief. Surgical intervention is required in very few patients.
Lifestyle changes include changes such as posture and ergonomic corrections, activity modification and giving up smoking. Incorrect posture while working on laptops, mobiles etc can cause excessive cervical spine strain with certain professions being more prone to develop neck pain.Medications: Different types of medications such as anti-inflammatory drugs, muscle relaxants, painkillers acting on the nerves (neuropathic agents) are used depending on the cause of pain and severity of symptoms. Sometimes stronger painkillers may also be suggested by your pain specialist.
EPIDURAL INJECTION (Nerve Block)
This injection is performed under real time x-ray guidance and delivers anti-inflammatory medicine in the epidural space, close to the affected nerve. It can help in recovery by reducing inflammation and the sensitivity of the nerves carrying the pain signals. The relief from these injections may be short term or long term, lasting from days to years. In some, it may even be permanent if the original problem responsible for pain heals. These injections can help to reduce pain so that you can resume normal activities and engage in a physical therapy program.
To find out more about Cervical Radiculopathy get in touch with Pain Specialists at Max Hospital.
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