This is no fun. Your neck hurts and you also have pain down your arm with some numbness, tingling and maybe even some burning sensations too. You just might have a cervical radiculopathy. Cervical refers to the neck, where the first seven vertebrae are called the cervical vertebrae and radiculopathy comes from the Latin “radix” or root and “pathy” from disorder/diseases/dysfunction.
Simply put, a cervical radiculopathy is a fancy way of saying a “pinched nerve.” You see the spinal cord carries all the information to and from your brain to the rest of your body. It travels inside a protected canal formed by the many bones of your spine called the vertebrae. The spinal cord then separates into bundles of nerves which travel out of the spinal cord through little openings or “foramen.” The nerves then pass into your muscles and travel to your arms, legs and organs. These nerves then allow you to move, walk, digest, feel, touch and so much more. Each nerve has different functions. Some help you feel cold or hot, others help you move your arm up or down and still others feel vibration, pain or other sensations. Now if one of these nerves gets pinched as it exits the spinal cord, you can develop problems. Dependent on what that nerve does, you may develop numbness, weakness, tingling, burning or other uncomfortable sensations in the area the nerves bring energy to. In the case of a cervical radiculopathy, the nerves that exit the cervical spine travel into the shoulders and out to the hands, so your symptoms would be into the shoulders and arms.
You may be wondering what pinches the nerves as they exit the spinal column. That is the million-dollar question when you come to the clinic to see us. First, we have to determine if it is really a cervical radiculopathy, or is it some other problem like referred pain from the shoulder, or myofascial pain from a recent car accident or something else. If after a careful history and neurologic examination we think it is a radiculopathy, then we’re back to asking what is compressing the nerve.
Your nerves can get pinched by a herniated disc, arthritis in the bones or other big, bad ugly stuff like tumors or abnormal balls of blood vessels called AVM’s. The most common causes are the discs. As you age, the discs dry out and are more likely to protrude back. Of course, the older you get the more likely you are to develop arthritis too. The arthritis or protruding discs can make the canal the nerves travel through smaller and can cause your symptoms. The good news is that your body is extraordinarily tolerant. It adapts very well to change. Even if one of your nerves get’s pinched, if the pinch is not too significant, the nervous system has the ability to adapt and within weeks to months your symptoms whether of weakness, numbness or tingling, all resolve. A simple analogy is that you may get used to living in a mansion and if you moved into a small one bedroom apartment things would be pretty crowded, but after a while you would get used to it and things wouldn’t be so bad. Your nerve is used to a certain amount of space in the small channel through which it exits the spinal column. When it gets squeezed at first it is very uncomfortable but it quickly get’s used to the smaller home.
For most people neurofunctional acupuncture, massage, a progressive exercise program and appropriate medication use are enough to support them as their nerves adapt. There is however a small group of people that due to the severity of the radiculopathy which may be causing severe and unremitting pain or progressive weakness or numbness will require surgery to free the nerve from compression. Each case is unique, but fortunately only a small minority require surgery. If you are having neck and arm pain or numbness and tingling and it is not improving, talk to your health care provider or come see us. Together we can help improve pain and restore function.
To learn more about cervical radiculopathy or to schedule a consultation, contact us.