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Cervical Radiculopathy

  • Also known as a pinched nerve, this condition involves shooting pain from the neck to the arm
  • Symptoms include an intense pain that runs from the neck into different parts of the arm
  • Treatment includes activity modification, medications, physical therapy, steroid injections, surgery
  • Involves neurosurgery, orthopedic surgery, and physiatry
Photo by Robert A. Lisak

Overview

If you have cervical radiculopathy, commonly referred to as a pinched nerve in the neck, you are probably used to living with pain. Trauma or normal aging has caused a nerve in your neck to become compressed or irritated, and your pain may be accompanied by numbness and/or weakness radiating into the shoulders and arms. 

The right medical care can provide relief. Yale Medicine General Orthopedics specialists offer a variety of cutting-edge approaches to repairing cervical radiculopathy that can eliminate pain and restore quality of life. 

What are the symptoms of cervical radiculopathy?

“Pressure on one of the nerves in the neck may cause an intense, shooting pain that goes from the neck into different parts of the arm,” says Peter G. Whang, MD, a specialist in diseases of the cervical, thoracic and lumbar regions of the spine. The part of the arm that hurts depends on which nerve is involved, Dr. Whang says. The condition can arise suddenly or develop over time.

What causes cervical radiculopathy?

The irritated and compressed nerve can be a result of arthritis or a disc herniation, or a less common condition, such as a tumor, infection or traumatic injury. Unhealthy lifestyle habits such as a sedentary behaviors, obesity and tobacco use may also put people at risk for cervical radiculopathy.

How is cervical radiculopathy diagnosed?

The doctor will take a patient’s history and perform a physical examination that may reveal signs of nerve irritation such as numbness or weakness in the arm. “The diagnosis is confirmed using magnetic resonance imaging (MRI), which will show if any of the nerves are being compressed by discs or arthritis,” Dr. Whang says. 

How is cervical radiculopathy treated?

Initial management for cervical radiculopathy focuses on nonoperative methods to improve the patient’s symptoms. “I’ll discuss how a patient can modify activities and initiate conservative therapies–including anti-inflammatory medications and physical therapy–to reduce symptoms related to pressure on the nerve,” Dr. Whang says. Steroid injections may be another option for patients who do not experience relief.

While many patients will respond to these nonoperative treatments, there are surgical methods available for those with persistent complaints. “The presence of neurological deficits such as numbness and weakness in the arm may be a reason to consider surgery,” Dr. Whang says.

How does surgical treatment help patients with cervical radiculopathy?

The goals of surgery are to decompress the nerve and stabilize the spine, and the surgical plan is individualized for each patient. Depending on the location of the problem, surgery may be performed from the front or through the back of the neck. The options include fusion (removing the disk and joining the two adjacent bones) or disc replacement (inserting a prosthetic device that restores range of motion).

Yale Medicine surgeons often use such advanced technology as navigation under image guidance or a robotic surgical platform that offers enhanced visualization and precision when performing procedures to correct cervical radiculopathy.

Depending on the surgery, the patient may return home the same day or spend a night or two in the hospital. “Recovery from neck surgery is typically easier than back surgery,” Dr. Whang says, “so most patients feel better in about a week or so.” By four to six weeks, most patients will have resumed all normal activities.

What makes Yale Medicine’s approach to cervical radiculopathy unique?

With cervical radiculopathy, “there are multiple surgical techniques that can be effective, but one size does not fit all,” Dr. Whang says. "You want to know that your surgeon has expertise in working with the newest techniques and technological advances.”

Yale New Haven Hospital is equipped to treat patients with a wide range of conditions, and Yale Medicine orthopaedic surgeons are continually honing their skills by performing a high volume of challenging surgical procedures, says Dr. Whang.