Cervical Radiculopathy (Pinched Nerve)
Cervical radiculopathy, often called a "pinched nerve" occurs when a nerve in the neck is compressed or irritated where it branches away from the spinal cord. This may cause pain which radiates into the shoulder, as well as muscle weakness and numbness which travels down the arm and into the hand.
Cervical radiculopathy is commonly brought on by "wear and tear" changes that occur in the spine as we grow older, such as arthritis. In younger people, it is most often triggered by a sudden injury that leads to a herniated disk. In many cases, cervical radiculopathy reacts well to conventional treatment which includes medication and physical therapy in Mexico, MO. Central Missouri's physical therapy and orthopedic experts at Audrain Orthopaedics have supplied you with the following info so you can be well-informed on the vital topic of cervical radiculopathy.
Your spine is comprised of 24 bones, called vertebrae, that are stacked atop one another. These bones hook up to create a canal which safeguards the spinal cord. The seven small vertebrae which commence at the base of the skull and form the neck comprise the cervical spine. Cervical radiculopathy takes place in the cervical spine-- the seven small vertebrae that form the neck.
Other parts of your spine include:
Spinal cord and nerves. These kinds of "electrical cables" travel through the spinal canal carrying messages in between your brain and muscles. Nerve roots branch out from the spinal cord with the help of openings within the vertebrae (foramen).
Intervertrebral disks. Between your vertebrae are flexible intervertebral disks. They serve as shock absorbers whenever you walk or run. Intervertebral disks are flat and rounded and about a half inch thick. They are comprised of two elements:
- Annulus fibrosus. This is the tough, flexible outer ring of the disk.
- Nucleus pulposus. This is the soft, gelatinous center of the disk.
Cervical radiculopathy most typically arises from degenerative changes which occur in the spine as we get older or from an injury which causes a herniated, or protruding, intervertebral disk.
Degenerative changes. As the disks in the spine age, they lose height and begin to bulge. They also lose water content, start to dry out, and get stiffer. This problem triggers settling, or collapse, of the disk spaces and loss of disk space height.
As the disks lose height, the vertebrae shift closer together. The body responds to the collapsed disk by developing more bone-- called bone spurs-- around the disk to strengthen it. These bone spurs contribute to the stiffening of the spine. They might also narrow the foramen-- the little openings on each side of the spinal column where the nerve roots exit-- and compress the nerve root.
Degenerative changes in the disks are usually called arthritis or spondylosis. These changes are normal and they take place in everyone. In fact, almost half of all individuals middle-aged and older have worn disks and pinched nerves which do not result in painful symptoms. It is not known why a number of patients develop symptoms and others do not.
Herniated disk. A disk herniates when its gelatinous center (nucleus) prods against its outer ring (annulus). If the disk is really worn or damaged, the nucleus may squeeze all the way through. Whenever the herniated disk bulges out toward the spinal canal, it puts pressure on the sensitive nerve root, causing pain and weakness in the area the nerve supplies. A herniated disk frequently occurs with lifting, pulling, bending, or twisting movements.
In most cases, the pain of cervical radiculopathy begins at the neck and journeys down the arm in the area served by the damaged nerve. This pain is usually referred to as burning or sharp. Specific neck movements-- like extending or straining the neck or turning the head-- might increase the discomfort. Other signs and symptoms include:
- Tingling or the feeling of "pins and needles" within the fingers or hand
- Weakness within the muscles of the arm, shoulder, or hand
- Reduction of sensation
Some patients report that pain lessens when they place their hands on top of their head. This movement may briefly relieve strain on the nerve root.
After talking about your medical history and general health, your Mid MO doctor will talk to you about your symptoms. He or she will then check out your neck, shoulder, arms and hands-- looking for muscle weakness, loss of sensation, or any change in your reflexes. Your doctor may also ask you to perform certain neck and arm movements to attempt to recreate and/or alleviate your symptoms.
X-rays. These offer images of dense structures, such as bone tissue. An x-ray will show the alignment of bones along your neck. It can also reveal whether there is any narrowing of the foramen and damage to the disks.
Computed tomography (CT) scans. More detailed than a plain x-ray, a CT scan can help your doctor determine whether you have developed bone spurs near the foramen within your cervical spine.
Magnetic resonance imaging (MRI) scans. These kinds of research studies make better images of the body's soft tissues. An MRI of the neck can show if your nerve compression is brought on by damage to soft tissues-- like a bulging or herniated disk. It can also help your physician figure out whether there is any type of harm to your spinal cord or nerve roots.
Electromyography (EMG). Electromyography determines the electrical impulses of the muscles at rest and during the course of contractions. Nerve conduction studies are often done alongside EMG to figure out if a nerve is performing normally. Together, these tests could serve to help your doctor identify whether your symptoms are triggered by pressure on spinal nerve roots and nerve damages or by a different problem that causes damage to nerves, including diabetes.
It is crucial to note that most patients with cervical radiculopathy improve with time and do not require treatment. For certain patients, the pain goes away pretty quickly-- in days or weeks. For other folks, it may take a bit longer.
It is also common for cervical radiculopathy that has improved to return at some point down the road. Even when this takes place, it normally improves without any specific treatment. In some cases, cervical radiculopathy does not improve, however. These types of individuals need assessment and treatment.
Preliminary treatment for cervical radiculopathy is nonsurgical. Nonsurgical treatment possibilities include:
Soft cervical collar. This is a padded ring that wraps around the neck and is held in place with Velcro. Your doctor might urge you to wear a soft cervical collar to allow the muscles within your neck to rest and to restrict neck motion. This could help lower the pinching of the nerve roots which accompany movement of the neck. A soft collar should only be worn for a very short time period since long-term wear might reduce the strength of the muscles within your neck.
Physical therapy. Specific exercises could help ease discomfort, strengthen neck muscles, and boost range of motion. In certain situations, traction can be used to gently stretch the joints and muscles of the neck.
Medications. In some cases, medications may help greatly improve your symptoms.
Nonsteroidal anti-inflammatory medicines (NSAIDs). NSAIDs, including aspirin, ibuprofen, and naproxen, might give relief if your pain is triggered by nerve irritation or inflammation.
Oral corticosteroids. A short course of oral corticosteroids might help diminish pain by decreasing swelling and inflammation around the nerve.
Steroid injection. In this method, steroids are injected near the impacted nerve to decrease local irritation. The injection may be placed in between the laminae (epidural injection), in the foramen (selective nerve injection), or right into the facet joint. Though steroid injections do not alleviate the pressure on the nerve brought on by a narrow foramen or by a bulging or herniated disk, they may lessen the swelling and relieve the pain long enough to permit the nerve to recuperate.
Narcotics. These medicines are reserved for patients with serious pain that is not eased by other choices. Narcotics are normally prescribed for a limited time only.
If following a period of time nonsurgical treatment does not ease your symptoms, your doctor might advise surgery. There are several surgical procedures to treat cervical radiculopathy. The procedure your doctor recommends will depend upon lots of factors, including what symptoms you are experiencing and the location of the involved nerve root.
When it comes down to it, the main point to bear in mind with cervical radiculopathy is that it is not something you ought to handle by yourself. Doctor Kathleen Weaver of Audrain Orthopaedics would like to consult with you if you are dealing with a pinched nerve so you can build a pinched nerve treatment plan that is individualized to your needs.