What is Cervical Radiculopathy?
Compression of a cervical nerve root as it exits the spine through its bony tunnel (foramen), producing pain, sensory changes and sometimes weakness in the corresponding dermatomal and myotomal pattern of the arm and hand.
Causes
Disc herniation pressing into the foramen; bone spurs (osteophytes) from age-related arthritis; loss of disc height narrowing the foramen; cervical spondylosis (osteoarthritis of the joints at the back of the spine); thickened ligaments.
Symptoms
Sharp, burning or shooting pain travelling from the neck into the shoulder, arm or hand. Pins and needles or numbness in a specific part of the arm or hand. Weakness in a particular muscle group — for example weakness gripping, lifting the arm, or extending the wrist. Symptoms often worsen with extending or rotating the neck towards the affected side, and arm pain is often more severe than the neck pain itself.
Diagnosis
History of the pattern of arm pain, neurological features and triggers. Examination of neck range of motion and a focused neurological assessment of the arms (strength, sensation, reflexes), with provocative tests such as Spurling’s manoeuvre. EMG can help confirm which nerve is affected when the picture is unclear.
Imaging
MRI is the investigation of choice — showing the disc, the nerves and the spinal cord in detail. CT for bony foraminal anatomy. X-ray for alignment, instability and degenerative change.
Treatment
Most patients improve substantially with 6–12 weeks of conservative care. Non-surgical management: relative rest, structured physiotherapy (postural retraining, deep-neck-flexor and scapular strengthening, nerve mobilisation), medications, and CT-guided cortisone injections around the affected nerve. Surgery — typically ACDF, cervical disc replacement, or posterior foraminotomy — is considered when symptoms are severe, long-standing, unresponsive to non-surgical treatment, or when there is progressive weakness.