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Cervical Radiculopathy

Compression-Induced Cervical Nerve Root Disorder

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Nöroloji department. Book Appointment →

What is Cervical Radiculopathy?

Cervical radiculopathy refers to dysfunction of cervical nerve roots due to compression, traction, irritation, or inflammation, most often at the C5-C7 levels (C7 most common, 60% of cases).

Etiologies: cervical spondylosis with foraminal stenosis (older patients) or acute disc herniation (younger patients).

Less common causes: tumor (neurofibroma, schwannoma, metastases), infection (epidural abscess, vertebral osteomyelitis), trauma (avulsion injury), inflammatory (sarcoidosis, varicella-zoster).

Pathophysiology: mechanical compression and chemical inflammation of the dorsal root ganglion and spinal nerve.

Annual incidence: 80-100 per 100,000 in adults, peak 50-54 years.

Most cases self-limited: 75-90% resolve with conservative management within 4-6 months.

Symptoms

Neck pain with radiation to upper extremity in dermatomal distribution.
C5: pain in deltoid/lateral arm, weakness in shoulder abduction, biceps weakness, biceps reflex diminished.
C6: pain in lateral arm/thumb, weakness in elbow flexion/wrist extension, brachioradialis reflex diminished.
C7: pain in middle finger/posterior arm, weakness in elbow extension/wrist flexion, triceps reflex diminished.
C8: pain in ulnar fingers, weakness in finger flexion, intrinsic hand muscle weakness.
T1: weakness in finger abduction, intrinsic hand wasting (rare).
Numbness, tingling, paresthesias in dermatomal distribution.
Pain worse with neck extension/rotation toward affected side (Spurling test).
Relief with shoulder abduction (Bakody sign).
Spasm of cervical paraspinals.

Risk Factors

Age 50-54 years peak incidence.
Smoking (degenerative disc disease).
Heavy lifting, repetitive neck movements.
Driving vibration exposure (occupational).
Prior cervical spine injury or surgery.
Family history of degenerative disc disease.
Genetic predisposition (collagen disorders).
Sports trauma (contact sports, diving).
Poor posture (prolonged forward head posture).

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent neck pain with arm radiation lasting more than 4-6 weeks.
  • New onset of arm weakness or numbness.
  • Bowel or bladder dysfunction (red flag for myelopathy).
  • Bilateral symptoms (concern for cervical myelopathy).
  • Fever, weight loss, night pain (red flags for infection or malignancy).
  • Trauma with new neurological symptoms.
  • Failed conservative therapy after 6-12 weeks.
  • Progressive neurological deficits requiring urgent imaging.

Treatment Methods

01
Diagnostic workup: clinical examination (Spurling test, abduction relief, dermatomal mapping), neurological exam, reflexes.
02
Imaging: MRI cervical spine (gold standard, T1/T2/STIR sequences); CT myelogram if MRI contraindicated.
03
Electromyography (EMG)/nerve conduction studies for chronicity, severity, alternative diagnosis.
04
Conservative management (first 6-12 weeks):
05
Activity modification (avoid aggravating positions, brief rest).
06
NSAIDs or acetaminophen for pain.
07
Muscle relaxants short-term (cyclobenzaprine, methocarbamol).
08
Physical therapy: gentle traction, posture training, neck strengthening, postural correction.
09
Cervical collar short-term (limited use).
10
Oral corticosteroids (Medrol dose pack) for severe symptoms.
11
Selective nerve root block or epidural steroid injection (transforaminal or interlaminar) for refractory pain.
12
Surgical indications: progressive neurological deficit, failure of 6-12 weeks conservative therapy, severe disabling pain, myelopathy.
13
Surgical options: anterior cervical discectomy and fusion (ACDF, gold standard), cervical disc arthroplasty, posterior foraminotomy, posterior laminectomy.
14
Outcomes: 90-95% improvement with surgery; 70-90% with conservative management.
15
Postoperative care: brief immobilization, gradual return to activity, physical therapy, follow-up at 6 weeks, 3 and 6 months.
16
Long-term: ergonomic modifications, regular exercise, smoking cessation, weight management.

Which Department to Visit?

You can visit our Nöroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.