Cervical radiculopathy, the medical term for a pinched nerve in the neck, can cause sharp pain and tingling in the shoulders, arms, hands and fingers. The specific symptoms depend on which of the 8 nerves in the neck area is involved. Sometimes an injury causes the pinched nerve, but many people over 50 develop the problem as the gel-filled discs that cushion the spaces between the bones of the neck, called cervical vertebrae, become damaged over time.
Location of Signs and Symptoms Most cases of cervical disc herniation can be diagnosed in the doctor's office, although sometimes magnetic resonance imaging -- MRI -- is needed, according to Dr. Mark Greenberg, author of "The Neurology Handbook, 7th ed." (Ref. 2, p. 461) In 69 percent of cases, the seventh cervical nerve -- C7 -- is compressed, affecting the triceps muscle at the back of the upper arm, the forearm, the second and third fingers, and all of the fingertips.
Dr. Greenberg notes that 19 percent of herniated cervical discs compress C6, the sixth cervical nerve, affecting the biceps muscle, the forearm, and the thumb. In 10 percent of the cases, compression of the C8 nerve affects the hand, and in 2 percent of cases, pressure on C5 affects the deltoid muscle of the arm, as well as the shoulder. Pain Typically, the first symptom of a herniated cervical disc is pain on 1 side of the neck. Often, the person first notices the pain upon waking in the morning, with no history of an injury. (Ref. 2, p. 461) The person may also have pain in the shoulder blade on that side, as well as in the arm, hand and fingers. Some people describe the pain as sharp, shooting or burning while others may perceive it differently.
The pain generally makes it difficult for the person to move the neck freely, and it may feel worse after bending the neck backwards. Standing, sitting, sneezing and coughing may also worsen the pain. Changes in Sensation Because the herniated cervical disc compresses the nerve root below it, people typically experience unusual sensations called paresthesias along the route of the nerve. Depending on the particular nerve affected, the person may feel numbness or tingling in the shoulder, arm or fingers of the affected side. (Ref. 2, p. 461) In milder cases, however, there may be no sensory changes at all because the nerve still functions properly. Muscle Weakness and Reflexes A herniated disc can cause muscle weakness and diminished reflexes in the arm and fingers. If the C7 nerve is compressed, the person may have difficulty extending the forearm, and the triceps muscle reflex may be diminished. (Ref. 2, p. 461) Compression of the C6 can cause weakness when the person flexes the forearm and diminished reflexes in the biceps and brachioradialis muscles. The fingerjerk reflex is diminished and hand movements are affected when the C8 nerve is compressed. The least common situation, compression of the C5 nerve, causes weakness and diminished reflexes in the deltoid muscle. Considerations
Since each cervical nerve sends electrical signals to different parts of the arm or hand on the affected side of the body, the location of the pain will vary depending on which nerve is pinched. Compressing the 7th cervical nerve, called C7, can cause pain in the triceps muscle of at the back of the upper arm to the middle finger, as well as weakness and tingling. (Ref. 6; Ref. 3, p. 461) A pinched C6 nerve can cause pain and tingling down the front of the arm to the thumb, while C8 compression can cause the similar symptoms on the little finger side of the arm. The least common site of a pinched nerve, C5, can cause pain in the shoulder.
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Most people with a pinched nerve in the neck recover without needing surgery, according to __. (Ref. ) Rarely, however, some people's conditions worsen despite conservative treatment of rest, pain medication and physical rehabilitation. Immediate medical attention is needed if both arms or legs become severely weakened and the person loses control of their bowels and bladder.
Is This an Emergency?
- Spine-Health: Conservative Treatment for a Cervical Herniated Disc
- University of Maryland Medical Center: Rehabilitation of Cervical Spine
- Handbook of Neurosurgery, 7th ed.; Mark S. Greenberg, MD
- American Association of Orthopaedic Surgeons: Cervical Radiculopathy (Pinched Nerve)
- HSS Journal: Cervical Radiculopathy: A Review
- Spine-Health: Cervical Herniated Disc Symptoms and Treatment Options