What Is the Best Treatment for Cervical Radiculopathy?

Cervical radiculopathy, or a pinched nerve in the neck, can be treated with neck immobilization, physical therapy, rest, and over-the-counter pain medication. Severe cases may require surgery to release the nerve compression.

Cervical radiculopathy is a condition in which a nerve in the neck is compressed or irritated (sometimes called a “pinched nerve”) where it branches away from the spinal cord.

What Are Symptoms of Cervical Radiculopathy?

Symptoms of cervical radiculopathy include: 

• Pain in the area served by the damaged nerve
  • Usually starts at the neck and travels down the arm
  • Described as burning or sharp
  • Neck movements may increase pain
  • Pain may decrease when hands are placed on top of the head because this can temporarily relieve pressure on the nerve root
• Tingling or “pins and needles” feeling in the fingers or hand
• Muscle weakness in the arm, shoulder, or hand
• Loss of sensation

Causes of cervical radiculopathy include: 

• Degenerative changes that occur with age 
  • Arthritis 
  • Spondylosis
• Herniated disk
• Nondegenerative causes
  • Infectious processes (especially herpes zoster and Lyme disease)
  • Diabetes mellitus 
  • Nerve root infarction
  • Root avulsion
  • Tumor
  • Infiltration by granulomatous tissue
  • Demyelination 

Cervical radiculopathy is diagnosed with a patient history and a physical examination that will check the neck, shoulder, arms and hands for muscle weakness, loss of sensation, or changes in reflexes.

Tests used to diagnose cervical radiculopathy include: 

• X-rays
• Computerized tomography (CT) scans
• Magnetic resonance imaging (MRI) scans
• Electromyography (EMG)

Frequently, cervical radiculopathy goes away on its own in days or weeks and treatment is not needed. 

When symptoms do not go away, treatment for cervical radiculopathy may include: 

• Nonsurgical treatment
  • Short-term neck immobilization with a hard or soft cervical collar and/or cervical pillow
  • Physical therapy with exercise and gradual mobilization
  • Avoidance of activities that cause pain
  • Cervical traction
  • Medications
    • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil Motrin), and naproxen (Aleve) to relieve nerve irritation or inflammation
    • Oral corticosteroids to help relieve pain by reducing swelling and inflammation around the nerve
    • Steroid injection to reduce local inflammation
    • Narcotics for short-term relief of severe pain that is not relieved by other options
  • Surgical treatment
    • Anterior cervical diskectomy and fusion (ACDF)
    • Artificial disk replacement (ADR)
    • Posterior cervical laminoforaminotomy