In our last post we discussed severe neck pain caused by a cervical radiculopathy. When a nerve root in the neck is irriated or compressed, a patient will show certain signs and symptoms. Lets find out what some of these classic symptoms are:
If the C5 nerve root is irritated or compressed, a patient will exhibit certain pain patterns and neurological changes. The pain will be concentrated in the neck, upper arm, shoulders, and medial border of the scapula. The patient may also show numbness and tingling in the upper arm specifically in the arm and deltoid muscles. The Doctor may notice a decreased biceps reflex and the patient is not able to bring their arms sideways up towards their ears (abduction) to the level of the shoulder or above.
Patients who have a radiculopathy that involves the C6 nerve root will present with neck pain, shoulder pain, medial scapula pain, thumb and index finger pain. They may have numbness and tingling into the outer aspect of the lower arm, into the thumb and index finger. The Doctor may notice that the brachioradilis and biceps reflex is decreased or absent. With motor testing, the doctor may also notice that the patient has weakness with wrist extension and the ability to bend the elbow.
Patients who present with a C7 radiculopathy will show have neck pain, lower arm and along the medial border of the scapula. They may experience numbness and tingling into the middle finger. The Doctor may notice an absent triceps reflex. Weakness may also be noticed in the ability to straighten the elbow, and weakness in the triceps muscle, wrist flexors and finger extensors.
Patients who have a c8 radiculopathy may present with neck pain, scapula pain, pain along the inner side of the arm, ring and little fingers. They may also have numbness and tingling in the ring and little fingers. Weakness may be noted in the finger flexors.
It should be noted that even if you have been diagnosed with a certain level of radiculopathy your symptoms may be different from the classic symptoms that we have listed above. Radiculopathic pain is not limited to one specific distribution pattern and may not always be sharp, and shooting and superficial in nature. Instead often times, the pain is all over the place, not just localized to one area and can be deep in nature. One reason for this because of the referred scleretogenous pain that comes from irritaton of the dural sleeve which is densely innervated.
As you can see, each nerve controls a lot of different sensations, muscles and reflexes. What causes irritation or compression to the cervical nerve roots in the first place?