Cervical Radiculopathy (Nerve Root Compression)
Cervical radiculopathy, which involves nerve root compression in the cervical spine, may be causes by cervical herniated discs, cervical spinal stenosis, and cervical degenerative disc disease.
Cervical Radiculopathy involves the compression of one of the nerve roots that exits the cervical spine or one of its main nerve branches. The cervical spine includes the first seven vertebrae, beginning at the base of the skull and ending just above T1 - the first vertebra of the thoracic spine. The cervical spine include these vertebra, as well as the intervertebral discs between the bones and the associated structures that involve movement and protection. Symptoms of Cervical Radiculopathy include somatic pain near the main pain generator (the physical source of the pain) as well as referred pain to the structures that main nerve branch supplies. Because of the nerve root compression associated with Cervical Radiculopathy, the condition often involves sharp and dull pain around the neck and shoulders as well as neurologic changes as well, including numbness, burning, tingling, and weakness. This condition may require aggressive treatments, if the affected nerves are compressed to the point that the pressure on them cause atrophy and lack of oxygen to the structures they supply information to. The areas where the patient experiences symptoms will relate to which nerve roots in the neck are affected. For example, if the patient's condition involves the patient having difficulty or discomfort with neck extension, these symptoms indicate a likely nerve root compression at the level between the last cervical vertebral and the first thoracic vertebra. If the patient's symptoms involve the patient having difficulty or discomfort with movements of their wrist, these symptoms indicate a likely compression of the nerve roots that exit the spine at the level between C5-C6. The patient's condition may indicate the compression of one or more of the nerve roots in the cervical spine. When more than one nerve roots are affecting the patient physically and neurologically, the condition is known as cervical Polyradiculopathy.
There are a wide range of causes and treatment options for this condition, which we will discuss in more detail below.
The nerve roots of the cervical spine may be injured or affected as a result of an injury, degenerative changes to the soft tissues, or due to a secondary disease. Let's take a look at some of the causes of cervical radiculopathy.
- Cervical Herniated Disc: Herniated discs are the most common causes of both chronic neck pain and chronic back pain. When a cervical herniated disc occurs, a tear in the outer rings of the disc opens up wide enough for the materials in the nucleus to be expelled outwards. When this material from the nucleus presses into the cervical nerve root, it may cause pain along any anatomical parts that nerve roots, or its sub-branches, supplies. This condition may get better on its own, but does not, in some cases. Often, the herniated cervical disc is able to heal itself, but the disc itself does not have a good mechanism for reabsorbing this inner disc material while its tear begins to close. This part of the body also does have any anatomical parts specialized to reabsorb these materials back into the body. If the expelled contents of the nucleus are not fully reabsorbed by the body, it may continue to press into the nerve roots, causing both physical pain, as well as referred pain to the neck, shoulder, forearm, and hands.
- Cervical Spinal Stenosis: There are several causes of cervical spinal stenosis, including thickening of the spinal ligaments, thickening of the vertebral bones, bone spurs, tumors of the spine, osteoarthritis, and Spondylolisthesis. These changes may cause the space around the spinal cord itself to become squeezed, or where the nerve roots exit the spine through the intervertebral foramen.
- Cervical Degenerative Disc Disease: Other degenerative changes to the discs may cause radiculopathy, such as bulging discs, and degenerative disc disease, which may cause instability of the spine and reduce the space around the nerve roots.