If you have pain at the back of your shoulder, around the shoulder blade, or find you are getting pain radiating down one or both of your arms as far down as the fingers you may have a nerve being irritated or pressed upon/impinged in your neck. You may have cervical radiculopathy.
Cervical (neck) radiculopathy (nerve pain) occurs when a nerve root in your neck is pinched or compressed as it leaves the spinal cord. This can present as shoulder or arm pain radiating down as far as the fingers. You may experience altered sensation in parts of the arm/hand, and in some cases, you may notice reduced strength in the arm or that your grip is weaker.
The most common cause of cervical radiculopathy is degeneration of the intervertebral discs the vertebrae (the building blocks of the spine) and the surrounding supporting structures. A herniated disc and/or arthritic bone spurs can cause compression of a nerve root along its path as it leaves the spinal cord. The repetitive stress of sitting at a desk, working at a computer all day, is a common triggering factor of neck symptoms in individuals who already have wear and tear in their neck.
Other causes of nerve impingement is an acute disc bulge following trauma and less commonly, tumors and infections.
Symptoms of cervical nerve root irritation can be mistaken for shoulder pain, especially seeing that you may not always get neck pain. This is why getting an accurate diagnosis is crucial to developing a treatment plan.
In most cases, a clinical diagnosis can be made by taking a thorough medical history and clinical examination. The diagnosis is confirmed with magnetic resonance imaging (MRI).
Treatment options include physical therapy, medications, cervical steroid injections and surgery.
Cervical traction may provide temporary pain relief but this should be used with caution and under advice.
Cervical spondylotic myelopathy (CSM) is a condition where the spinal cord becomes compressed by the degenerative changes of the bones of the neck. This causes stiffness, weakness and numbness in the arms and legs (usually both). There may be bowel or bladder dysfunction in extreme cases.
CSM is most common in people who are older than 50 years old and can cause severe pain and disability.
If you are experiencing neck pain, numbness, tingling, weakness, or paralysis in one or both arms, hands, legs, and feet, make an appointment to see a medical professional at the earliest opportunity.
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First, we must understand what spondylosis is.
Most joints in our body are made up of the end of two bones that articulate with each other inside a joint capsule. When the joint surfaces undergo wear the joint is described as being arthritic. The way the bones in the spine relate to each other though is more complex.
The spine is made up of building blocks called vertebrae. These relate with adjacent vertebrae through a combination of the intervertebral discs, which act as shock absorbers, and facet joints that articulate at the rear. These vetebral segments are stabilised by ligament structures just like any other joint. Because of this unique makeup when degeneration occurs in the spine, we refer to it as spondylosis.
Cervical spondylosis is a condition that affects the bones and discs in the neck. It is caused by the wear and tear of the spine over time and is more common in older adults.
The majority of people with cervical spondylosis have no symptoms or at most report the occasional neck pain and stiffness, otherwise known as cervicalgia. This can be associated with a headache. A common trigger for this is prolonged sitting in front of a computer screen.
In more advanced cases you may experience numbness or weakness in the arms or legs as nerves of the spinal cord get impinged. See cervical nerve impingement.
If you suspect your symptoms are the result of cervical spondylosis, it is important to seek a doctor's opinion. Your doctor can carry out a physical examination and may order imaging tests, such as x-rays or MRI, to confirm the diagnosis and determine the extent of the condition. Having this information helps your doctor be able to safely recommend the course treatment that is most suited to you.
There are several ways to manage cervical spondylosis:
Some people will get temporary relief from chiropractic or osteopathic manipulation techniques but take note that these therapies are not without risk and should only be carried out by experienced practitioners. Make sure you are aware of potential complications of manipulations and your practitioner explains these before you agree to undergo treatment.
Risks from cervical spine manipulation include spinal cord injury, nerve compression, and stroke. So, in my opinion, do not have your neck manipulated if you know you have bony changes, are experiencing pins and needles or tingling in your arms or legs, or you recently developed sudden severe neck pain and an accompanying headache.
If you are experiencing severe neck pain, weakness or numbness in the arms or legs, or difficulty walking this could be a sign of inflammation of the spinal cord known as cervical myelopathy.
Cervical myelopathy can be caused by:
It is important to seek medical attention right away. These symptoms may be a sign of a more serious condition and require urgent attention.
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