Radicular Pain

What is it? Cervical radicular pain is defined as pain perceived as arising in the arm caused by irritation of a cervical spinal nerve or its roots.

Statistics: A large study in Rochester, Minnesota, has reported the annual incidence of cervical radicular symptoms to be 83.2 per 100,000 population, and its prevalence most significant within a 50- to 54-year age group. In the study, 90 percent of patients were asymptomatic or only mildly incapacitated.

Approximately 1 person in 1,000 suffers from cervical radicular pain. In the absence of a gold standard, the diagnosis is based on a combination of history, clinical examination, and (potentially) complementary examination.

Important Facts: A common cause of neck, shoulder and arm pain is a ruptured or herniated cervical disc. Symptoms may include dull or sharp pain in the neck or between the shoulder blades, pain that radiates down the arm to the hand or fingers, or numbness or tingling in the shoulder or arm. Certain positions or movements of the neck can intensify the pain. This pain is referred to as Radicular Pain or Cervical radiculopathy.

The pain often feels like an electric-like or throbbing sensation that shoots down your arm and hand. This pain may worsen when you cough or sneeze. In addition, it is important to be aware of signs of a problem involving your cervical spine (e.g., loss of the ability to control your bowel or bladder or difficulty with balance) that may require surgical evaluation.

Treatment Duration: About 90% of patients with cervical radicular pain recover in 12 weeks. Furthermore, it seems that there is no benefit at 12 months from having surgery or physiotherapy over no intervention. However, those having surgery generally recover quicker.2

The overall prognosis of persons with cervical radiculopathy is favorable. Most patients improve over time with a focused, nonoperative treatment course. There is little high-quality evidence on the best nonoperative therapy for cervical radiculopathy.

Do’s/Don’ts: Home cervical traction units may decrease radicular symptoms. In theory, traction distracts the neural foramen and decompresses the affected nerve root. Typically, eight to 12 lbs. of traction is applied at an angle of approximately 24 degrees of flexion for 15- to 20-minute intervals. Traction is most beneficial when acute muscular pain has subsided and should not be used in patients who have signs of myelopathy.

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