Cervical Radiculopathy: Symptoms, Causes and Treatment

What Is Cervical Radiculopathy?

Cervical radiculopathy describes symptoms that arise when one of the nerve roots leaving the cervical spine becomes irritated or compressed.

These nerves carry sensory and motor signals between the spinal cord and the shoulder, arm and hand.

As a result, a problem originating in the neck can cause symptoms some distance away from the cervical spine itself.

What Are the Symptoms of Cervical Radiculopathy?

Symptoms vary depending upon which nerve root is affected and the degree of irritation or compression.

They can include:

• neck pain
• shoulder pain
• pain travelling into the arm
• burning or shooting pain
• pins and needles
• numbness
• altered sensation
• muscle weakness
• changes in reflexes

Some patients experience predominantly arm pain with relatively little discomfort in the neck.

What Does Cervical Radicular Pain Feel Like?

Patients may describe cervical radicular pain as:

• sharp
• shooting
• electric
• burning
• stabbing
• deep aching

The pain may travel from the neck or shoulder into the upper arm, forearm, hand or fingers.

Read more: Neck Pain and Arm Pain: Could It Be a Trapped Nerve?.

Can Cervical Radiculopathy Cause Tingling or Numbness?

Yes.

Because cervical nerve roots carry sensory information, nerve irritation can cause:

• pins and needles
• tingling
• burning sensations
• reduced sensation
• areas of numbness

The pattern of altered sensation may help indicate which nerve root is affected, although symptoms do not always follow a perfectly defined pattern.

Can Cervical Radiculopathy Cause Weakness?

Yes.

If nerve compression affects motor function, weakness can develop in muscles supplied by the affected nerve.

Depending upon the nerve involved, this may affect:

• shoulder movement
• elbow movement
• wrist movement
• grip strength
• finger movement

New, significant or progressively worsening weakness should be medically assessed promptly.

What Causes Cervical Radiculopathy?

The most common causes are conditions that reduce the space around a cervical nerve root.

These include:

• cervical disc prolapse
• disc degeneration
• bone spurs, or osteophytes
• facet joint changes
• foraminal narrowing

The cause can vary with age and individual anatomy.

Can a Cervical Disc Prolapse Cause Radiculopathy?

Yes.

A cervical disc prolapse can protrude towards a nearby nerve root and cause irritation or compression.

This may produce arm pain, tingling, numbness or weakness corresponding with the affected nerve.

Read more: Cervical Disc Prolapse: Symptoms and Treatment.

Can Age-Related Changes Cause Cervical Radiculopathy?

Yes.

As the cervical spine changes with age, the discs can lose height and the joints can enlarge or form osteophytes.

These changes can narrow the neural foramen, which is the opening through which a nerve root leaves the spine.

If the narrowing becomes sufficient to affect the nerve, cervical radiculopathy may develop.

What Is Foraminal Stenosis?

Foraminal stenosis means narrowing of the opening through which a spinal nerve root leaves the cervical spine.

It can result from:

• disc degeneration
• disc bulging
• osteophytes
• facet joint enlargement
• a combination of these changes

If a nerve root is compressed within the narrowed foramen, radicular symptoms can occur.

Which Cervical Nerves Can Be Affected?

Several cervical nerve roots contribute to sensation and muscle function in the upper limb.

Depending upon the level involved, symptoms may affect different areas of the:

• shoulder
• upper arm
• forearm
• hand
• fingers

A neurological examination can assess whether the pattern of pain, sensation, muscle strength and reflexes corresponds with a particular nerve root.

Does Cervical Radiculopathy Always Cause Neck Pain?

No.

Some patients experience predominantly arm symptoms and relatively little neck pain.

This can occur because the irritated nerve carries symptoms away from the cervical spine into the areas it supplies.

Can Cervical Radiculopathy Affect Both Arms?

It can, although a single nerve-root problem commonly affects one side.

Symptoms in both arms, particularly when accompanied by hand clumsiness, leg symptoms, balance problems or walking difficulty, may indicate a more central problem affecting the spinal cord rather than an isolated nerve root.

These symptoms require careful assessment.

How Is Cervical Radiculopathy Diagnosed?

Diagnosis begins with the clinical history and neurological examination.

A clinician may assess:

• where the pain travels
• which areas feel numb or tingling
• muscle strength
• reflexes
• neck movement
• shoulder function
• whether particular positions reproduce symptoms

The aim is to establish whether the symptoms fit a cervical nerve-root pattern and whether another condition could explain them.

Can Shoulder Problems Mimic Cervical Radiculopathy?

Yes.

Shoulder disorders can cause pain in the shoulder and upper arm and sometimes coexist with cervical spine problems.

A shoulder problem may be more strongly related to shoulder movement, while cervical radiculopathy is more likely to produce neurological symptoms such as tingling, numbness or weakness.

However, there can be considerable overlap, so clinical examination is important.

Can Carpal Tunnel or Ulnar Nerve Problems Mimic Cervical Radiculopathy?

Yes.

Peripheral nerve compression can produce tingling, numbness and weakness in the hand and fingers.

Examples include:

• carpal tunnel syndrome
• ulnar nerve compression

The distribution of symptoms, neurological examination and occasionally nerve conduction studies can help distinguish a peripheral nerve problem from cervical radiculopathy.

Do I Need an MRI for Cervical Radiculopathy?

Not every patient requires immediate imaging.

MRI may be appropriate when:

• significant symptoms persist
• there is muscle weakness
• neurological symptoms are worsening
• the diagnosis is uncertain
• spinal cord compression is suspected
• an intervention or surgery is being considered

MRI can show the cervical discs, nerve roots, spinal canal and areas of narrowing.

What Does an MRI Show in Cervical Radiculopathy?

An MRI may identify:

• a cervical disc prolapse
• disc degeneration
• foraminal stenosis
• osteophytes
• nerve-root compression
• spinal canal narrowing

However, abnormalities on MRI can also be present in people without symptoms.

The scan therefore needs to be matched with the patient's clinical presentation.

Does an Abnormal MRI Mean I Need Treatment?

No.

Degenerative cervical changes are common, particularly with increasing age.

The presence of an abnormality does not automatically mean it is responsible for the symptoms or that treatment is required.

A clinically meaningful finding is one that fits the patient's pattern of pain, neurological symptoms and examination findings.

Can Cervical Radiculopathy Get Better Without Surgery?

Yes. Many cases improve without an operation.

Non-surgical management may include:

• remaining appropriately active
• exercise and rehabilitation
• physiotherapy where appropriate
• appropriate pain management
• temporary modification of aggravating activities

The appropriate treatment depends upon symptoms, neurological findings and the underlying cause.

How Long Can Cervical Radiculopathy Last?

The duration varies between individuals.

Some episodes improve over several weeks, while others persist for longer.

Factors that can influence recovery include:

• the cause of the nerve compression
• the severity of symptoms
• whether weakness is present
• the duration of nerve irritation
• the individual's general health

Persistent or worsening symptoms may justify specialist assessment.

When Might Surgery Be Considered for Cervical Radiculopathy?

Surgery may be considered when significant symptoms persist and imaging demonstrates nerve compression that corresponds with the clinical findings.

Factors may include:

• persistent severe arm pain
• substantial functional limitation
• significant or progressive muscle weakness
• persistent neurological symptoms
• failure to improve with appropriate non-surgical treatment
• corresponding MRI findings

The decision should balance the likely benefit of relieving the nerve compression against the risks of surgery.

What Operations Are Used for Cervical Radiculopathy?

The appropriate operation depends upon the location and cause of the nerve compression.

Procedures may include approaches that remove the disc material, bone or other structures compressing the nerve.

In selected patients, surgery may involve:

• anterior cervical discectomy and fusion
• cervical disc replacement
• posterior cervical foraminotomy

The most appropriate procedure depends upon the individual anatomy, spinal level involved and other clinical factors.

What Is an Anterior Cervical Discectomy and Fusion?

An anterior cervical discectomy and fusion, often abbreviated to ACDF, is an operation performed through the front of the neck.

The affected disc is removed to decompress the nerve or spinal cord, and the operated spinal level is then stabilised and fused.

It is one of several possible operations for cervical nerve compression and is not required for every patient with radiculopathy.

What Is Cervical Disc Replacement?

Cervical disc replacement involves removing a damaged disc and replacing it with an artificial disc designed to preserve movement at that spinal level.

It may be appropriate for selected patients, but suitability depends upon factors including anatomy, age-related changes and the specific cause of nerve compression.

What Is a Posterior Cervical Foraminotomy?

A posterior cervical foraminotomy is performed from the back of the neck and aims to enlarge the space around a compressed nerve root.

It can be suitable for selected forms of foraminal nerve compression.

The appropriate surgical approach is determined individually.

What Is the Difference Between Cervical Radiculopathy and Cervical Myelopathy?

Cervical radiculopathy involves a spinal nerve root and commonly causes symptoms in one arm.

Cervical myelopathy involves compression of the spinal cord and can affect neurological function more widely.

Possible symptoms of myelopathy include:

• clumsy hands
• difficulty with fine finger movements
• balance problems
• leg stiffness or weakness
• unsteadiness when walking

These symptoms require medical assessment.

Can Cervical Radiculopathy and Myelopathy Occur Together?

Yes.

A patient can have compression of both an individual cervical nerve root and the spinal cord.

This can produce a combination of arm pain or numbness together with broader neurological symptoms such as hand clumsiness or walking difficulty.

Read more: Cervical Spinal Stenosis: Symptoms and Treatment.

When Should I See a Spine Specialist?

Specialist assessment may be appropriate when:

• arm pain is severe or persistent
• tingling or numbness persists
• weakness develops
• symptoms interfere substantially with work, sleep or normal activities
• symptoms are getting worse
• the diagnosis remains uncertain
• an MRI or surgical treatment is being considered

Assessment can help determine whether a cervical nerve root is responsible and whether further investigation or treatment may be appropriate.

When Does Cervical Radiculopathy Require Urgent Assessment?

Most cervical radiculopathy is not a medical emergency.

However, neurological deterioration or symptoms suggesting spinal cord compression require more urgent assessment.

Seek prompt medical advice if symptoms are associated with:

• new or progressively worsening weakness
• increasing clumsiness of the hands
• difficulty with buttons, handwriting or other fine hand movements
• new balance problems
• unsteadiness when walking
• weakness or altered sensation affecting the legs
• new bladder or bowel disturbance associated with neurological symptoms

These features may indicate cervical spinal cord involvement rather than an isolated nerve-root problem.

Frequently Asked Questions About Cervical Radiculopathy

Is cervical radiculopathy the same as a trapped nerve?

Cervical radiculopathy is the medical term used when irritation or compression of a cervical nerve root causes neurological symptoms. Patients often describe this as a trapped nerve in the neck.

Can cervical radiculopathy cause arm pain without neck pain?

Yes. Some patients have predominantly arm pain, tingling or numbness with relatively little neck discomfort.

Can cervical radiculopathy cause numb fingers?

Yes. Depending upon which cervical nerve root is affected, numbness or tingling can extend into particular areas of the hand and fingers.

Can cervical radiculopathy cause weakness?

Yes. Significant nerve compression can impair muscle function. New or worsening weakness should be medically assessed.

Does cervical radiculopathy always require an MRI?

No. Imaging is not necessarily required immediately, particularly when symptoms are improving. MRI may become appropriate for persistent neurological symptoms, weakness, diagnostic uncertainty or treatment planning.

Does cervical radiculopathy usually require surgery?

No. Many cases improve without surgery. An operation may be considered for persistent significant symptoms, progressive weakness or other clinically important nerve compression.

Is cervical radiculopathy dangerous?

Most cases are not dangerous, but progressive weakness or symptoms suggesting spinal cord compression require prompt medical assessment.

About This Article

This article provides general information about cervical radiculopathy, its symptoms, causes, diagnosis and treatment. It is not intended to diagnose an individual's symptoms or replace personalised medical advice.

Medically reviewed by Professor Nasir A. Quraishi
Consultant Spinal Surgeon & Honorary Professor

Clinical sources: NICE guidance on suspected neurological conditions, NHS information about cervical spondylosis and neck pain, and established clinical guidance on cervical nerve-root compression.

Further Information About Cervical Radiculopathy

If neck or arm symptoms are persistent or associated with numbness or weakness, specialist assessment can help determine whether cervical nerve compression is present and whether further investigation or treatment may be appropriate.

Learn more about Cervical / Neck Pain

What Causes Neck Pain?
Neck Pain and Arm Pain: Could It Be a Trapped Nerve?
Cervical Disc Prolapse: Symptoms and Treatment
Cervical Spinal Stenosis: Symptoms and Treatment
When Does Neck Pain Require Surgery?