Cervical radiculopathy is a clinical condition where one or more cervical nerve become swollen or damaged, resulting in changes in the normal neurological functions.
Neck pain, numbness in the hands, wrists, and arms, alteration in the normal reflexes, numbness, weakness, and sensations of pins and needles may arise due to impingement on the affected nerve.
Pathophysiology In Relation To the Structure of Spinal Column
The vertebral column is made up of 33 bones stacked upon one another, which protect our spinal cord. These bones are held in the right place by a network of muscles, ligaments, and tendons. Spinal nerves arise from the vertebral column and spread to the different areas of the body, including the legs, feet, hands, and arms.
When one of these nerves becomes compressed, it may lead to painful symptoms.
Causes of Cervical Radiculopathy
There may be many causes of cervical radiculopathy, but the most important ones are described below.
- Stenosis of Cervical Foramen (foramina). A foramen is an opening in the bone through which a nerve root enters or exits the canal of the vertebral column. When a foramen becomes narrow or gets smaller, the nerve root is left with less space and becomes impinged.
- Cervical herniated disks. A disc hernia is said to take place when the inner soft jelly-like material of an intervertebral disc comes out of its outer ring called the annulus fibrosis. A herniated or bulging disc irritates and inflames the adjacent nerve roots which result in the form of cervical radiculopathy.
- If any part of the vertebral bone is damaged due to a fracture, the spine becomes unstable and the foramen gets narrower, or it may also lead to spondylolisthesis. These issues may then lead to a pinched nerve that may also become inflamed.
- Spinal infections specifically and the systemic infections less commonly may result in swelling of the nerve roots which are then damaged.
- When lumps (granulomas) are formed in the cervical region, that will cause cervical radiculopathy due to nerve compression.
- Bone spurs.
Risk Factors for Cervical Radiculopathy
Some factors that may enhance the risk for the development of cervical radiculopathy include:
- Advancing age. This risk is at the peak point in a person of 40 to 50 years of age.
- Strenuous activities that exert high levels of stress on the cervical spine, such as heavy weight lifting practice or wrestling.
- Repetitive neck vibrations or motions
- Diabetes causes the alteration of blood flow to the nerves and thus the risk of nerve impinging is increased.
There are also some other risk factors which enhance the risk for one to suffer from nerve impinging. These include heavy smoking , being overweight, poor body posture, poor lifting techniques, repeated motions and a family history of degenerative bone diseases.
Cervical Radiculopathy Symptoms
The symptoms of the persons suffering from cervical radiculopathy tend to include:
- Pain in the arm, wrist, shoulders, neck and upper back region.
- Weakness in all these areas.
- Numbness in the arms and hands
- Tingling sensations.
- Sensations of pins and needles.
Diagnosis
The doctor diagnoses this condition after asking for a thorough medical history of the patient, followed by a general physical examination. If necessary, he/she can order relevant investigations for the confirmation of diagnosis.
These include radiological investigations, i.e. X-Ray, CT scan and MRI and some other investigations that include electromyography which is an electrical impulse testing. It is done to test the function of nerves.
Treatment
Commonly, radiculopathy can be treated through nonsurgical treatment. Your doctor may start with a conservative treatment at first and prescribe some medications depending upon the severity of the condition.
Oral medications or steroid injections are also prescribed to reduce swelling. If pain is very severe, narcotic painkillers are given.
Additionally, the patient is advised to wear a soft cervical collar to support the neck. Physical therapy also has good results in this regard. You can also apply hot or cold fomentations to reduce pain and swelling (including that of the soft tissues).
Prevention from Radiculopathy
You can avoid nerve compression and inflammation by adopting certain strategies which are described as following:
- By adopting good posture even during driving or sitting in front of the TV
- By adopting good lifting techniques
- Performing regular and adequate physical activity including aerobics and weight-bearing exercises
- Maintaining your weight within the normal limits of BMI.
- Taking frequent short breaks during periods of continuous sitting
- By doing frequent stretching practice
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