Nerve root dysfunction, which is usually secondary to chronic pressure or invasion of the root, causes a radicular syndrome of pain and segmental neurologic deficit.
Cervical (neck) disk syndrome involves pain, numbness, and muscular spasm of the neck, radiating to the shoulders, caused by irritation and compression of the cervical nerve roots by a protruding intervertebral disk.
Mass lesions - benign or malignant - in the cervical area, especially in patients with narrow canals, may compress both the root and spinal cord, adding a myelopathy to a root syndrome.
Radicular pain is precipitated by movement of the spine, coughing, or sneezing.
Cervical radiculopathy is similar in nature to problems that can occur in other areas of the spine. For example, lower lumbar and high sacral roots that form the sciatic nerve can, if compressed or injured, produce pain in the buttocks, posterior lateral thigh, calf, and foot (sciatica). Cervical root pain radiates into the shoulders, arm, hand, or occiput, depending on the cervcial vertebrae involved.
Cervical Radiculopathy is caused by anything that injures or compresses the nerve root as it travels out from the spine. Injury, arthritis, and spread of cancerous lesions are all potential causes.
Plain spine films may show arthritis or metastatic disease. CT scans define the dimensions of the bony canal and lateral recess encroachment. Myelography outlines soft tissue planes and delineates the level and often the extent of a disk protrusion. MRI gives excellent images of spinal lesions and may replace myelography in many situations.
Specific therapy depends on the etiology of the radicular syndrome. In cervical root lesions, traction as well as a cervical collar effectively relieves muscle spasm, even when nerve root involvement and motor weakness are present. It is usually applied at home for one hour three to four times daily, using weights.
The required amount of pull varies according to the person’s size and body type and whether traction is applied supine or sitting. Neck position during traction is important. The most comfortable straight or mildly flexed position is used; extension should be avoided.
Traction is applied through a head halter, with the weight attached on a rope threaded through a pulley placed above and slightly in front of the seated or supine patient. The frequency of treatments may be decreased as symptoms subside.
If static home traction does not provide relief, intermittent traction using a motorized device in a physical therapy facility may help.
Drug therapy, is sometimes helpful. Hospitalization for further evaluation is indicated if motor weakness progresses or weakness or pain does not rapidly subside. Surgical decompression is usually quite effective if non-surgical therapy fails.
What is causing the nerve root problem?
What do the test results indicate?
Is further testing and evaluation required?
What are treatment options?
Do you recommend a cervical collar?
Will traction be needed?
Is surgical decompression a possibility?