Spine · Conditions

Cervical Radiculopathy: Definition, Causes, Risk factors and Complications

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What is cervical radiculopathy? It is a condition that affects the nerve roots of the cervical or upper portion of the spine. The nerve roots that are usually affected are those of the sixth and the seventh cervical vertebrae. Damaged nerve roots can lead to pain or loss of feeling in the areas where the nerve passes through and the feeling can move to the hand. However, these effects depend on the location of the damaged root.

Types of cervical radiculopath

When trying to understand what is cervical radiculopathy, symptoms of the condition usually differ, and this entirely depends on the affected nerve. For instance, C5 radiculopathy can happen if the nerve root running above the C5 vertebra is affected.

Even though the specific symptoms vary depending on the patient, the following are some descriptions of the types of cervical radiculopathy depending on their symptoms.

  • C5 radiculopathy – it causes weakness and pain in the upper arms and shoulders of the patient. C5 radiculopathy can also cause discomfort around the shoulder blade area. In rare cases, this condition can bring about numbness or tingling.
  • C6 radiculopathy – this condition mostly causes pain and weakness in the entire arm, especially in the wrists, the index finger and thumb, and biceps.
  • C7 radiculopathy – patients with this condition usually complain about pain or weakness which can extend from the neck to the arm, especially in the triceps and the middle finger.
  • C8 radiculopathy – it causes pain which extends from the neck of the patient to their hand. Patients normally complain about weakness in their hand grip and numbness and pain radiating in the inner part of their arm, and also in the ring and little fingers.

The cervical spine has seven cervical vertebrae, which are the bones which form the neck part of the body. These bones are separated by intervertebral discs, which absorb shock for the spine. Every cervical vertebra has a canal, which allows the spinal cord to travel through. Spinal nerve roots begin from the spinal cord and then extend to different parts of the arm. If abnormal pressure is applied to where these nerves originate, everything along the nerve's path is affected.

The affected nerve cannot relay messages from the brain to the muscles, or receive the appropriate feeling from that part of the arm where this nerve travels through.

The following factors can cause pressure to the spinal nerves:

  • Arthritis or wear and tear or cervical discs.
  • Herniated or protruding discs as a result of disc degeneration or trauma.
  • Narrowing of the spinal canal.
  • Tumor intruding the nerve root.

Prevalence

Cervical radiculopathy does not happen nearly as often as lumbar radiculopathy, a condition that affects the lumbar or lower portions of the spine. Cervical radiculopathy affects people of all ages, and they require cervical radiculopathy treatment exercises to manage the condition.

Research has shown that the following mechanisms are responsible for causing nerve root impingement or irritation:

  • Spondylosis – it is more common in elderly people, and causes bony spurs or stenosis.
  • Disc herniation – it is prevalent among younger people.

According to statistics, cervical disc herniation accounts for 20% to 25% of cervical radiculopathy cases in young people. Herniated discs in younger people mostly occur because of an injury that causes a pinched nerve. In older patients, the condition is usually the result of changes brought about by aging, such as degenerative changes. Bone spurs often occur as a result of normal wear and tear on the spine and its supporting structures. Intervertebral discs become dry and shrink as a result of the aging process. Doctors say that most of the aged people show symptoms of the above conditions when turning up for cervical radiculopathy treatment exercises.

This condition mostly affects people between the ages of 40 to 50 years, at a reported prevalence rate of 51.03%. A research conducted in the US regarding the prevalence of cervical radiculopathy showed that the condition is less prevalent compared to lumbar radiculopathy. Statistics from the research indicate that out of every 100,000 people, 83 of them have cervical radiculopathy.

Cervical radiculopathy occurs more frequently in women than men, as it accounts for 53.69% of all the reported cases. Close to 50% of all cervical radiculopathy patients in the US live in large metropolitans. 39.27% of cases are reported to be from southern regions in the United States. A study conducted in Minnesota revealed the rate at which common nerve root compressions occurs:

  • C7 at a rate of 46.3% to 69%
  • C6 at a rate of 17.6% to 19%
  • C5 at a rate of 2% to 6.6%
  • C8 at a rate of 6.2% to 10%

Incidence of neck pain as a result of cervical spondylosis which contributes to cervical radicular in adults is estimated to be between 20% and 50% every year. Statistics show that cervical spondylosis affects both men and women at the same rate. An estimated 95% of people aged 65 years and above are affected by cervical spondylosis to some level, and researchers say that it is the major contributor of spine dysfunction in aged people.

75% of people above the age of 50 have shown notable signs of a narrowing spinal canal, and 50% of these incidences are symptomatic. The number of symptomatic cases increases to 75% for people aged 65 and above. Changes in the cervical spine because of spondylosis happen at the single level of every disc space in 15% to 40% of patients and multiple levels of disc space in 60% to 85% of patients.

Risk factors

There are some known risk factors associated with the development of cervical radiculopathy. Also, some of the risk factors are cervical radiculopathy causes. They include:

  • Smoking – Smoking affects almost every tissue and organ in our bodies, including the spine. Smoking is among the main causes of degenerative disease, which weakens the vertebral discs. The degenerative disease can lead to an individual developing cervical radiculopathy, so, smokers are at a higher risk of developing the condition.
  • Operating vibrating equipment – vibrating equipment, especially which require us to use a lot of energy, exert some pressure on our cervical spines. Handling the equipment for a long time can make the cervical discs to burst, causing a lot of pressure to the nerves. People handling vibrating equipment are therefore at a considerable risk of cervical radiculopathy.
  • Poor posture – poor neck posture is mostly overlooked when trying to determinecervical radiculopathy causes. What you should understand is that poor neck posture can cause an individual to have weak neck muscles. This can cause pain which extends from the neck to the arms.
  • Poor sleeping positions – people with poor sleeping habits can strain their spines and cause damage to their cervical discs. If the discs are affected to the point where the surrounding nerves are also affected, the person can be at risk of developing cervical radiculopathy.
  • Frequent lifting of more than 25 pounds – lifting heavy objects can put pressure on cervical discs. Prolonged exertion of pressure to these discs can make them crack or collapse, placing the person at risk of cervical radiculopathy.
  • Age – as a person grows old, their intervertebral discs become stiff and provide less support to the spine. In addition, their bones and ligaments thicken and begin to intrude on the spinal canal, leading to a condition known as cervical spondylosis.
  • Occupation – some jobs involve a lot of repetitive neck movements, uncomfortable neck positioning or doing overhead work, activities that strain your neck. Engaging in such activities for a prolonged period is likely to put you at risk of cervical radiculopathy.
  • Neck injuries – people with history of neck injuries are at an increased risk of developing cervical radiculopathy.
  • Genetic factors – people from families with a history of cervical radiculopathy are more likely to develop the condition compared to those without any history.
  • Engaging in high-impact or rough sports – some sports put more pressure on the neck, putting the players at a high risk of developing cervical radiculopathy.
  • Other risk factors that are less frequently associated with cervical radiculopathy include spinal tumors, giant cell arthritis, and spinal infections.

Additionally, people with the following conditions risk developing cervical radiculopathy.

  • Bone spurs or osteophytes
  • Individuals with spinal stenosis

Reasons

While the symptoms of cervical radiculopathy have been extensively studied and documented, how this condition develops has still not been fully understood. The most common symptoms of cervical radiculopathy have their roots in the inflammation that results from the compression of nerve roots.

It is thought that substances are released by bulging or herniated discs causing the nerve roots to become inflamed and swollen. The pressure on the nerve roots may be caused by breakdown in the spinal discs – a normal part of aging, changes in the vertebrae, or other factors that eventually lead to cervical radiculopathy.

Research has shown that patients with cervical disc disease experience pain similar to that of cervical radiculopathy when a nerve root is pinched or compressed. All the same, when pressure is exerted on a disc, pain is felt in the neck and along the inner edge of the shoulder blade. Additionally, there have been instances in the past where muscle spasms have been produced by electrically stimulating discs.

The main causes of cervical radiculopathy include:

Cervical herniated disc

Herniated discs mostly occur when too much pressure is applied on a healthy intervertebral disc. For example, a car accident can lead to herniated disc if your head hits the windshield. Such accidents apply too much force on the neck, a force which can’t be evenly absorbed by a healthy neck. This leads to an injury.

The different movements of our necks cause different kinds of pressure on the spinal bone and disc. The disc acts as a shock absorber to the pressure applied to the vertebrae. The disc between the vertebrae is compressed if you bend your neck forward. Consequently, this exerts a lot of pressure on the disc, causing a swelling that extends toward the spinal cord and the nerve roots.

Cervical herniated disc can also happen as a result of a disc being weakened by a degenerative process. Once the disc has been weakened, it can rupture or tear even with the tiniest pressure being applied to it.

The pressure causes the internal material of the affected cervical disc to leak out and cause inflammation to the nearby nerves. In fact, most cervical radiculopathy cases seen in young people between the ages 20 and 30 show symptoms of cervical radiculopathy related to cervical herniated disc.

Cervical degenerative disc disease

When a cervical disc degenerates, it becomes stiffer and flatter, making it susceptible to collapse because of the degenerative disease. Affected cervical spine discs usually don’t offer the required support to the spine. The body reacts to the collapsed disc by developing more bone, known as bone spurs, in order to strengthen the affected disc. These bone spurs can stiffen the spine and the small openings where the nerve roots exit on the spinal column and pinch the nerve root.

In some scenarios, cervical degenerative disc disease can cause inflammation to the nerve root near the affected disc. The inflammation causes pain which begins from the neck and runs down all the way to the hand. At times, a person can experience numbness in areas where the nerve provides feeling.Cervical degenerative disc disease is the main cause of cervical radiculopathy in individuals aged 5 years and above.

Cervical spinal stenosis

Cervical spine degenerative processes can tighten the area of the spine where the nerve roots exit thus causing pressure to the nerves. Cervical spinal stenosis causes cervical radiculopathy related symptoms in people aged 60 and above.

Cervical radiculopathy
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