Cervical Radiculopathy

Question 1

ESSENCE

Answer 1

Describes range of symptoms produced by pinching of a nerve

Question 2

AETIOLOGY

Common causes

Answer 2

• Degenerative changes of discs with age giving pressure to nerve roots
• Ruptured disc as result of trauma
• Infections of spine
• Tumours of spine

Question 3

AETIOLOGY

Risk factors

Answer 3

• Smoke
• Past history
• Lift heavy items
• Drive equipment that vibrates
• Golf

Question 4

CLINICAL FEATURES

Presentation

Answer 4

• Pain that spreads into arm, neck, chest, upper back and/or shoulders
  
  • Unilateral
• Sensory issues
  
  • Numbness or paraesthesia
• Motor problems
  
  • Muscle weakness, lack of coordination, loss of reflexes

Question 5

INVESTIGATIONS

First choice

Answer 5

• Various investigations used
  
  • MRI for nerve or soft tissue damage
  • X-ray to look for narrowing of vertebral openings
  • CT for more detailed cervical spine
  • Electromyography to see hour muscles work when rest and contracted

Question 6

MANAGEMENT

General principles

Answer 6

• Sometimes do not require treatment if symptoms get better with time
• Conservative treatment with medication and physiotherapy
• Surgery

Question 7

MANAGEMENT

Medication

Answer 7

• Corticosteroids or NSAID to reduce inflammation