Definition and Overview

Cervical radiculitis refers to pain felt in the uppermost section of the spinal column. It thus affects the neck and shoulders. It can radiate and spread to other parts of the body, including the arms and hands.

The condition is commonly known as a pinched nerve. It can occur when a nerve (or its root) in the neck area is compressed or irritated. It can occur due to a number of factors, including certain diseases. Sometimes, it goes away on its own without treatment. In other cases, it progresses and worsens. Severe cases may lead to permanent nerve damage. These can also lead to loss of muscle tissue and muscle weakness.

The intensity of pain varies. It can be mild or severe and debilitating. In the worst situation, it may cause some form of disability. Fortunately, the disease responds to medications and therapy very well. Surgery is also an option for serious cases.

Causes of Condition

The spinal column is composed of 24 bones (vertebrae) that help protect the nerves. The first seven run from the base of the skull to the neck. In between these bones are discs. These discs have a sturdy outer cover that protects the jelly-like material inside them. They serve two functions. First is to provide flexibility to the spine. The second is shock absorption. They help reduce the risk of injury to the spine.

The spinal cord consists of nerves. These nerves are responsible for carrying incoming and outgoing messages between the brain and the rest of the body.

Cervical radiculitis can occur as a result of the following:

  • Disc problems - These problems can include bulging and herniated discs. These terms are sometimes used interchangeably. But there is a minor difference. A herniated disc may begin as a bulging disc. Either way, it means that the disc has slipped. The condition is often due to degeneration. The affected disc may then rupture. Many factors can cause disc problems. The most common is ageing. This causes the natural wear and tear of the discs. Worn out discs can pinch the nerves or their roots. Disc issues usually occur in the lumbar spine. This is the lowest part of the spinal column. When it occurs in the neck region, it is referred to as cervical disc herniation.

  • Spine injuries - Any injury to the spine can increase the risk of cervical radiculitis. This often occurs when there is damage to the discs, which can result in radiating pain.

  • Bone spurs (osteophytes) - These are bone projections. They develop on existing bones. They can occur in different areas of the body. These include the feet and spine. The leading cause is bone degeneration. It may also be due to local inflammation, such as arthritis. Bone spurs may eventually pinch a nerve.

  • Spine-related conditions - There are many diseases and conditions that can affect the spine. An example is scoliosis. This refers to the abnormal curvature of the spine. Another is spondylolisthesis. This occurs when the upper bones move toward the lower ones.

Key Symptoms

The most common signs of the condition are tingling sensation and increasing pain in the neck and shoulder region. Many patients also complain of numbness of the affected area, muscle weakness, and lack of muscle coordination. These often occur when the disease has already progressed or left untreated for a very long time. Other common complaints include a feeling of physical discomfort, muscle spasm, and loss of sensation.

Who to See and Types of Treatments Available

The condition is treated by doctors specialising in bone conditions (orthopaedic doctor). Depending on its severity, the patient’s medical team may also include physical therapists and chiropractors.

To diagnose the condition, the doctor begins with a review of the patient’s medical history. This is often followed by a physical exam and imaging tests.

During the physical exam, the doctor will assess the pain intensity in relation to movement. He or she will also look for other key symptoms. These include the patient’s inability to grip objects. Patients are also asked if they are experiencing muscle spasms. Imaging tests are also used to obtain images of the cervical spine. Commonly used are x-rays and magnetic resonance imaging (MRI).

Mild cases may not require any treatment. With adequate rest, the condition may resolve on its own. Treatment for moderate and severe cases, on the other hand, may involve non-surgical and surgical therapies. These include a procedure called anterior cervical discectomy and fusion (ACDF). Another option is the removal and replacement of the damaged disc.

Pinched nerve surgery has a high success rate. It can be carried out using minimally invasive methods. Recovery time may take less than a month.

Non-surgical treatment, on the other hand, focuses on relieving symptoms and reducing inflammation. This may include the following:

  • Medications - Certain medications are used to control pain. They are also used to treat other symptoms, such as muscle spasms. In more severe cases, the doctor may provide epidural steroids. It is a strong medication that suppresses pain.

  • Chiropractic - This involves the manual manipulation of the spine. This therapy can cure or speed up healing. It may also improve mobility and reduce pain. It may take several sessions to treat the condition.

  • Neck collars - Cervical collars help limit neck movement. This allows the affected area to heal faster.

  • Physical therapy - This is used to help improve or restore mobility. It can also help correct posture. In many cases, it is also used for pain management. Most patients require multiple sessions to achieve the desired treatment outcomes.

References:

  • Radhakrishnan K, Litchy WJ, O’Fallon WM, Kurland LT. Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990. Brain. 1994 Apr. 117(pt 2):325-35.

  • Nordin M, Carragee EJ, Hogg-Johnson S, et al for the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Assessment of neck pain and its associated disorders: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008 Feb 15. 33(4 suppl):S101-22.

  • Anderberg L, Annertz M, Brandt L, Säveland H. Selective diagnostic cervical nerve root block–correlation with clinical symptoms and MRI-pathology. Acta Neurochir (Wien). 2004 Jun. 146(6):559-65; discussion 565.

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