One of the most common misdiagnoses we see in our office is arm nerve pain
being blamed on carpal tunnel syndrome or other local arm entrapment syndromes because
neck radiculopathy (aka a local neck impingement) or a double crush syndrome that has not
been considered first.
Disc herniation accounts for 20-25% of the cases of cervical
radiculopathy or neck-related arm nerve pain. In the younger population, cervical
radiculopathy is a result of a disc herniation (bulging disc) or an acute injury causing foraminal
impingement of an exiting nerve. In the older patient, cervical radiculopathy is often a
result of degenerative changes in the cervical spine and the domino effect on joint
arthritis.
Cervical Radiculopathy means there is irritation on one of the many nerves in the
neck due to inflammation and swelling of a structure called a disc (see pictures above),
which leads to shoulder, upper arm, lower arm, and hand symptoms (see Figure 2). These
symptoms follow the nerve path down to the hand causing numbness, tingling, burning,
weakness, and many other words that can be used to describe nerve pain. You typically
will also have local pain, muscle tightness, and can have local nerve pain.
To understand how the disc inflammation and injury happened, we need to talk
about anatomy. The spine is a big connection between many bones and joints. The bones
give us support and protect the body’s nervous system.
- These bones have a joint could a facet joint (see pictures above) and those joints health is affected by the health of the disc
- The disc is a cushion between most of the bones in the spine. Think of this being the jelly of a donut (see nucleus polposus pictures above)
- It also has a cartilage portion around the disc. Think about this as the bread that holds the jelly in the donut. (see annulus fibrosis pictures above)
- Lastly, there is a cartilage endplate. Think about the jelly donut being wrapped in foil to keep it warm (see vertebral endplate pictures above)
Now we can talk about how the radiculitis or your numbness and tingling
happened from a disc bulge injury. This started due to trauma, whether it is big, such as a fall or
a wreck, or from something small. Small damage from something like a job where you
have to move your neck continually can add up over time and cause as much trauma as a
big accident. This dysfunction or accident causes tears to begin to happen in the cartilage
or bread portion of our donut. Then the separation of the outer cartilage or the foil
wrapper happens. When this occurs nothing is left to hold the disc or jelly from leaking
out. Now, this jelly causes irritation (inflammation) on the facet joints and can cause
irritation to the body’s nerve system and you get nerve pain in your arms.
How do we get neck pain?
- Car wrecks
- Heavy manual labor
- Smoking
- Driving or operating vibrating equipment
Other, less frequent causes include
- Tumors of the spine
- Expanding cervical synovial cyst,
- Synovial chondromatosis in the cervical facet joint
- Giant cell arteritis of the cervical radicular vessels
- Spinal infections
What are common muscle and skeletal
diagnoses for nerve pain in the arms (See pictures above)?
- Cervical Radiculopathy- arm nerve pain coming from the neck
- Degenerative conditions
- Disc injuries
- Facet joint injuries
- Trigger points
- Entrapments:
- Thoracic outlet syndrome
- Carpal tunnel syndrome
- Tunnel of guyeon syndrome
- Cubital tunnel syndrome
- Pronator teres syndrome
- Ligament of struthers
- Rare vascular conditions: heart attack, strokes etc…
What Can You Feel With Radiculitis?
- Local neck pain
- Traveling arm pain in a nerve pattern
- Muscle weakness in a group of muscles supplied by a single nerve
- Loss of reflexes
- Headaches
- Shoulder pain
- Loss of strength
- Sensation of tingling, burning, or numbness
- Muscle tightness or spasms
Preventing your neck pain
- Exercise routine: See video below
- Use constant cueing to maintain good posture
- Take frequent stretch breaks
- Adjust your desk, chair, and computer so that the monitor is at eye level (90/90)
- Pay attention to how you use electronics, watch tv, and read, etc.
- Avoid carrying heavy bags with straps over your shoulder.
- Sleep in a position that maintains a neutral neck angle.
Common Conservative Treatment Options For Neck Pain
- Chiropractic Care
- Increases neck spinal joint movement
- Decreases irritation and inflammation
- Decreases muscle pain and stiffness
- Decreases the time spent in pain
- Massage therapy
- Decreases muscle pain
- Increases movement
- Increases proper healing
- Acupuncture
- Increases proper healing
- Decreases muscle pain
- Decreases inflammation and swelling
- Soft-tissue Therapy *An instrument or the hands can be used to do perform massage treatments
- Decreases muscle pain
- Increases movement
- Increases proper healing
- Rehabilitation Exercises or Physical Therapy
- Increases mobility
- Increases strength
- Decreases stiffness
- Decreases pain
We hope this blog will serve as a resource to help you feel empowered to back control of your neck pain and live a normal pain free life again.
If you would like to be screened to see if you are a candidate that could start receiving the
benefits of chiropractic care for your nagging neck pain in our office you can schedule here https://chiromskspecialists.janeapp.com.
We appreciate your continued interest in our blog. We will continue in the coming weeks with a blog that gives a detailed look at wear and tear arthritis called osteoarthritis.
