Cervical radiculopathy

The vertebrae, which protect the spinal cord and spinal nerves, through daily activities experience normal wear-and-tear. Sometimes this causes slight impingement of nerves, in turn causing spinal nerve inflammation and shooting pain down to the hand.

Radiating neck pain

Neck pain that shoots down the arm into some (not all) fingers can be due to cervical radiculopathy, which comes from impingement of the cervical spinal nerves by otherwise normal day-to-day wear-and-tear of the vertebrae.

Spinal nerves

Irritation of a cervical spinal nerve causes pain, spasm, and inflammation in body parts served by the nerve.

Areas of the skin served by a cervical spinal nerve is its dermatome. For example, the dermatome of the C6 nerve includes the thumb and index finger.

Spinal nerve irritation will also cause spasms of its myotome — muscles under its control. This causes alterations in posture & activities that cause secondary pain.

Nerve irritation can also cause neurogenic inflammation in involved peripheral tissue. This is mediated by interactions between nerve endings and the immune system.

Chronic pain cycle

Even if pain sources are identified, frequently pain involves the entire “chronic pain cycle”. Treatment requires comprehensive management including biomechanical & psychological treatments.

Symptoms

  • Shooting pain down to some of the fingers on one side
  • Spasms of shoulder, arm, forearm, and finger muscles
  • Neck & shoulder pain

Diagnosis

  • Physical examination
  • X-ray, CT, and/or MRI of the cervical spine
  • Other musculoskeletal conditions often co-exist
  • Rule out other “red flag” medical conditions

Treatment

  • Physical therapy strengthening the neck and shoulder muscles, improving posture
  • Epidural steroid injection under fluoroscopy guidance reduces inflammation around the spinal nerves.
  • Co-existing musculoskeletal conditions should also be treated.
  • Spinal cord stimulation (SCS) is sometimes an option for non-drug, convenient therapy.
  • Comprehensive pain management including pain psychology, physical therapy, and complementary & alternative medicine (CAM)

Neck pain

Dr. Ming Kao View All →

Pain physician & PhD computational biologist @StanfordPain • Advanced pain interventions with CIPS & FIPP • Opinions mine & not medical advice

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