Cervical radiculopathy refers to an abnormality affecting the nerves exiting the spinal cord at the level of the neck. Most commonly, this is irritation or pinching of the nerve by a herniated disc or bone spur. Pressure from the bulging disc or bone triggers symptoms in the distribution of the nerve that will affect the neck and upper extremities.
Pain
Cervical radiculopathy pain will typically evolve over time and can vary from a deep ache to a burning sensation, as discussed on emedicine.com. Headache, especially the back of the head, is common, notes the University of Maryland Spine Program. Pain may begin in the neck or upper trapezius muscles. It may also be felt in the area of the shoulder blade. There are seven cervical vertebrae, which each have nerves exiting below them. The pain distribution depends on which nerve root is affected and almost always is only on one side. Irritation of the upper nerves leads to discomfort in the lower neck and as the lower levels are affected, the pain moves down the shoulder to the upper arm and finally to the lower arm and hand, as outlined in American Family Physician. Pain is often worsened by turning the head and looking up and improved by moving the hand above the head, according to the same source.
Sensation Changes
Sensory symptoms may occur in the absence of pain. Tingling, burning or a "pins and needles" feeling may be present. Decreased sensation or numbness is also characteristic, as related by the emedicine.com article on cervical radiculopathy. Again, these symptoms will follow the distribution of the particular nerve that is injured. The fourth cervical nerve innervates in a cape pattern along the lower neck and upper shoulder with progressively lower nerves going to the outside upper arm, the thumb side of the forearm and, finally, the pinky side of the forearm as discussed in the American Family Physician article.
Weakness
Muscle weakness may result from irritation of the corresponding nerve as it leaves the spinal canal. Again, the specific muscles affected allows one to isolate the particular nerve involved. Muscles are affected in this descending order: biceps and elbow flexors, wrist extensors, triceps, wrist flexors and finger muscles. Weakness may be absent or mild and is particularly serious if significant.
Reflexes can also be affected by nerve irritation. Asymmetrical reflexes of the upper extremity may correlate with a cervical radiculopathy.
