Radiculopathy refers to disease of the nerve roots where they exit the spinal cord. Cervical refers to the neck region. Cervical radiculopathy typically occurs as a result of pressure on the nerve from a bulging intervetebral disc or a bone spur from a degenerative condition. Numerous treatment options exist, ranging from simple and safe conservative therapy to surgery.
Physical Treatments
Nonoperative treatment may be effective in more than 90 percent of patients, as reviewed in "American Family Physician: Nonoperative Management of Neck Pain and Radicular Symptoms." Initial treatments are generally simple and conservative and may progress to more invasive strategies as the situation warrants. Hard or soft neck braces can provide support to relieve pain. Traction, a technique to relieve pressure on the nerve, may be beneficial. A physical therapist may employ a treatment regimen consisting of range of motion exercises, stretching, massage, heat, ice and electrical stimulation. Manipulation of the cervical spine is not recommended due to lack of proof of effectiveness and the potential for injury, according to the authors of the "American Family Physician" and emedicine.com articles.
Medication
The cervical radiculopathy article on emedicine.com addresses the administration of nonsteroidal anti-inflammatory drugs, also called NSAIDS, for the treatment of this condition. These medications, such as ibuprofen, naproxen and aspirin, may diminish pain and swelling. Muscle relaxants can relieve discomfort associated with tightness and spasm of the neck muscles. Certain antidepressants and anticonvulsants may relieve nerve pain. Stronger pain medications containing narcotics may be employed. Oral steroids such as prednisone can reduce inflammation associated with the nerve irritation. These are generally prescribed for a 5-to-10-day course.
Injections
The University of Maryland Spine Program discusses the issue of epidural steroid injections in the treatment of cervical radiculopathy. The anti-inflammatory medication is injected near the source of the nerve irritation, often using X-ray guidance for placement. Occasionally, anesthetic nerve blocks may be used to relieve pain. Although rare, complications can be serious.
Surgery
Surgery is often a last resort for sufferers of cervical radiculopathy but may be necessary if there is progressive nerve damage or instability of the spine. It may also be considered for those in whom symptoms are not tolerable after more conservative methods have been employed. Surgical options include removal of the damaged portion of the disc or bone spur, or fusion of two or more vertebrae in the neck using rods and screws.
