I have neck pain that sometimes spreads to my arm. What causes this and how is it treated?
Neck and neck-related arm pain are common symptoms that affect people of many different ages, backgrounds, and activity levels. Pain in the neck and/or arm can result from numerous causes including what is often referred to as a “pinched nerve.”
A pinched nerve in the neck (specifically of the nerve root) is medically termed cervical radiculopathy, a word derived from the Latin word for “root” and the Greek word for “disease.” The average annual incidence rate of cervical radiculopathy is 83 per 100,000 people in the population, with an increased prevalence noted in the fifth decade of life.
Cervical radiculopathy (CR) is often caused by a herniated disc, or arthritis in the neck leading to stenosis (narrowing) of the space that the nerve root exits. These changes in the spine can occur as a result of trauma or from stresses that take place during normal life activities. Signs and symptoms of CR may include neck pain, upper-extremity pain, tingling, numbness, and/or weakness as well as decreased neck or arm range of motion. The impairments associated with CR often result in difficulty performing activities of daily living such as sleeping, dressing, bathing, or performing work or home related tasks. Athletes with CR may show decreased performance or inability to participate in their sport.
Diagnosing CR is done by a physician with the appropriate background. Your physician will take a detailed history and perform a physical exam in order to determine the likelihood that a pinched nerve in the neck is causing your symptoms. In certain cases, diagnostic testing such as an x-ray, MRI, and/or nerve conduction velocity test is required.
Conservative treatment for CR often includes medications for pain and inflammation as well as referral to a physical therapist. Physical therapy has been shown to be successful in the treatment of patients with CR. Current best-evidence physical therapy practice includes exercise targeting the muscles of the neck, chest, and upper back, manual therapy to the joints and surrounding soft tissues, neck traction, and postural education. A physical therapist will develop a specific program based on your impairments and personal goals. Some patients may not respond to conservative treatments and will require referral to a specialist for injections or surgery. It is important to note that many patients with CR do not require surgery.
If you are experiencing neck pain with or without arm pain, tingling, numbness, and/or weakness, it is recommended that you schedule an appointment with your physician. Cervical radiculopathy can be a debilitating condition, but with the proper diagnosis and subsequent treatment you can return to pain-free function and optimal quality of life.
The author of this article is Matt Johnson, PT, DPT, OCS from Athletico – Michigan Ave.