Cervical Radiculopathy

Your cervical spine is the upper portion of your backbone, located in your neck. It consists of seven bones separated by soft, cushion-like discs that act as shock absorbers.

Nerve roots branch out from the spinal cord through small openings between the vertebrae, called foramina. They carry signals between your brain and the rest of your body.

If the nerve root in the neck becomes compressed and irritated, signals can be disrupted. This results in the pain and neurological symptoms associated with cervical radiculopathy. This condition is more commonly known as a pinched nerve.

Cervical radiculopathy pain radiates from your neck down into your shoulder, arm, chest, or upper back. You may also notice numbness, tingling, muscle weakness, or changes in reflexes.

Symptoms can be frustrating. Most people, however, improve with non-surgical care, often within a few weeks or months. Surgery is rarely needed unless symptoms are severe or not improving with other treatments.

Why Does a Pinched Nerve Happen?

Sometimes the nerves in your neck can get irritated or compressed by the structures around them, like bones, discs, muscles, or ligaments. A pinched nerve in the neck can result from:

Age-related changes. Over time, the discs in your neck can dry out and flatten, a process called degenerative disc disease. This makes the space between your vertebrae smaller and puts more stress on the joints and ligaments in your neck. These age-related changes, often referred to as cervical spondylosis, can lead to bone spurs or disc bulges that press on nearby nerves.
Herniated disc. A crack in the outer layer of a spinal disc can allow the soft inner material to push out and press on a nearby nerve root.

In general, younger adults are more likely to have cervical radiculopathy from a herniated disc. Older adults often develop it from arthritis-related narrowing.

What Are the Symptoms to Watch For?

The signs of a pinched nerve in the neck can be surprisingly far-reaching. The symptoms you notice depend on the exact nerve root involved. Each nerve root connects to a specific pathway from the neck to the arm. By recognizing these patterns, your doctor can pinpoint the source.

Symptoms usually appear on one side of the body and can include:

Pain that may feel sharp, burning, or radiating down the arm
Numbness or a tingling, pins and needles sensation in the arm, hand, or fingers
Weakness in muscles controlled by the affected nerve
Changes in reflexes

How Is Cervical Radiculopathy Diagnosed?

Your doctor will physically examine your neck, arms, and hands. They’ll check muscle strength, sensation, and reflexes.
Imaging such as MRI is often used to look for a herniated disc, bone spurs, or nerve compression.

Other tests, like electromyography (EMG), may help confirm whether the nerve is functioning normally.

How Is Cervical Radiculopathy Treated?

Acute cervical radiculopathy means your symptoms have been present for a short time, usually less than 6 to 12 weeks. Early treatment focuses on calming inflammation and easing pressure on the nerve. The approaches used aim to restore comfort, avoid further strain, and give your tissues time to heal. Common treatment options include:

Short-term rest and support. Limiting strenuous activities for a few days, sometimes using a soft cervical collar to reduce motion, will give the nerve a chance to calm down.
Activity modification. Avoiding movements or positions that worsen your symptoms, such as looking down at devices for a long time, lifting things, or twisting your neck, can help.
Medications. Over-the-counter pain relievers like acetaminophen or anti-inflammatory medicines such as ibuprofen and naproxen can reduce pain and swelling around the nerve. In some cases, prescription-strength medications or a short course of oral steroids may be used.
Physical therapy. Guided stretches, posture training, and exercises to strengthen neck and shoulder muscles can improve healing and help prevent future flare-ups.
Cold or heat therapy. Ice packs help reduce inflammation in the early stages, while heat can help relax tight muscles after the initial pain eases.

If symptoms persist after weeks or months of taking these steps, your doctor may recommend targeted procedures to reduce them. Epidural steroid injections near the affected nerve root may be given to lessen swelling and pain.

When pain or weakness doesn’t improve or if nerve damage is progressing, surgery may be the most effective path forward.

The goal of surgery is to relieve the pressure on the nerve so it can recover. Several surgical approaches can be used, and the best option depends on your anatomy and the location of the nerve compression. Treatment may involve clearing bone and tissue from the back of the neck to give the nerve more space. It may also involve removing the damaged disc and either doing a cervical fusion or disc replacement.

Warning Signs to Watch For

These symptoms might point to a serious issue with your nerves or spinal cord. Quick action is needed to prevent lasting nerve damage and boost your chances of a full recovery.

New or worsening weakness in your arm or hand
Neck pain that radiates down your arm and doesn’t improve after a week of rest
Numbness that spreads or intensifies
Symptoms after an injury, such as a fall or car accident