The cervical spine is made up of seven vertebrae from the base of the skull through the neck. Eight pairs of nerves travel through bony openings in the cervical spine. When one or more of these nerves get pinched, painful cervical neuropathies can occur.
The most common symptom is pain that radiates from the neck down into the arms. The pain can be dull or sharp, and it can be on one side or both. When the pain is accompanied by numbness, tingling or weakness, it usually means that the nerve compression is more severe.
A physical exam is the first step in diagnosis. It is important to find out if there is any limitation of motion in the neck or any weakness or decreased sensation in the arms. Plain x-rays are always important to see if there is any disease of the bones of the cervical spine. Finally, magnetic resonance imaging (MRI) or CAT scans may be required.
There are a number of possible causes of pressure on a cervical nerve. The cause can be as simple as a muscle spasm or as serious as a tumor. The most common cause of pinched nerves in the neck is degenerative disease of the spine, a form of arthritis that can cause bony protrusions called "spurs" or herniation of the discs that lie between the bones.
The most common pain medicines given for cervical neuropathy are anti-inflammatory medications and antispasmodic medications. These medicines help relieve the tight muscles and inflamed nerves. A cervical collar (neck brace) is helpful to relieve the pressure on the nerves by supporting the neck and head. An injection of steroid medication is sometimes given at the spot where the inflamed nerve exits the bone. Narcotics are rarely given due to the addictive potential.
Sometimes simple measures do not work to relieve the pain of cervical neuropathy. At times, it can progress and lead to weakness in the arms. In these cases, surgery might become necessary. A ruptured disc might need to be repaired, or an unstable spinal column might need to be fixed into a firm position.
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