Cervical Radiculopathy Treatment in New Jersey

Smiling patient standing in outdoor park on sunny day Cervical radiculopathy develops when a nerve in the cervical spine (neck area) is compressed or irritated. In the adult age population, cervical radiculopathy affects about 85 per 100,000 people. Centers for Neurosurgery, Spine & Orthopedics (CNSO), treats patients with cervical radiculopathy throughout northern New Jersey. Learn more about this condition, its risk factors, and care plan options at CNSO.

What Is Cervical Radiculopathy?

When a nerve or the spinal cord in the neck becomes irritated or compressed, it causes pain, numbness, and muscle weakness. If these sensations radiate beyond the neck, such as down the shoulder, arm, or upper back, the condition is called cervical radiculopathy. By definition, radiculopathy originates at the point where the nerve root becomes impinged or pinched by an injury, bone disease formation, or a spinal tumor.

Causes and Risk Factors

For some patients, there is no obvious injury that resulted in cervical radiculopathy. However, several known causes could lead to this condition, including:
  • Natural aging process: Cervical radiculopathy often occurs due to age-related wear and tear in the cervical spine, as well as degenerative changes in the spine, such as arthritis or spondylosis.
  • Spinal disc herniation: This is when the disc’s annulus (outer ring), becomes deformed and the inner nucleus (jelly-like center) further distorts the disc outside of its normal confines. Pressure is placed on the surrounding sensitive nerve roots. If the herniated disc bulges into the spinal canal, it can cause bilateral arm weakness and pain by compressing the spinal cord.
  • Degenerative disc disease: With age, spinal discs begin to dry out, get stiff, and settle or collapse. When this happens, pain is the result of discs losing height and vertebrae rubbing together.
  • Bone spurs: The body’s natural response to degenerative disc disease, bone spurs are the formation of new bone to help strengthen intervertebral discs. However, bone spurs can cause stiffening in the spine, the narrowing of the intervertebral foramen, and pinched nerve roots.
  • Cervical stenosis: When the spinal canal is too narrow, the spinal cord and nerve roots can become damaged, sometimes resulting in cervical radiculopathy.
  • Traumatic spinal injuries: After a serious injury to the head, neck, or spine, cervical radiculopathy is common. It can be caused by a motor vehicle accident, accident at work, or sports injury.
Risk factors for cervical radiculopathy include:
  • Certain neck movements (i.e., straining or over-extending)
  • Driving
  • Heavy manual labor jobs that require lifting or operating vibrating equipment
  • Previous neck trauma or spinal nerve injury
  • Smoking

Recognizing Symptoms

Symptoms of this condition typically begin in the neck and radiate to the arms, shoulders, hands, or upper back such as the trapezius or scapular region. The onset of symptoms usually develops over time, though they can be immediate in cases of injury. Patients with cervical radiculopathy commonly experience signs and symptoms such as:

  • Burning or sharp pain
  • Difficulty driving, sleeping, working, or taking care of oneself
  • Limited range of motion
  • Loss of reflexes or sensation
  • Muscle weakness
  • Numbness and tingling in the arm
  • Other specific cervical nerve root symptoms

These symptoms may be shared with other symptoms, which is why patients should receive medical attention immediately if they experience weakness or loss of function.

Diagnosing Cervical Radiculopathy

Primary care doctors diagnose neck pain but not the cause. Neurosurgeons and orthopedic surgeons fellowship trained in spine diagnose cervical radiculopathy and its cause.

Generally, diagnosing the cause of neck pain and ruling out or ruling in cervical radiculopathy involves:

  • Physical examination:The patient’s neck, shoulders, arms, and hands are physically examined to check for pain distribution, paresthesia distribution, changes in reflexes, loss of sensation, and muscle weakness, along with other signs and symptoms.
  • Medical history assessment:The patient’s medical history is analyzed to determine whether there could be another condition or genetic factors causing neck pain or symptoms of cervical radiculopathy.
  • Diagnostic imaging tests: These may include X-rays, magnetic resonance imaging (MRI), and/or computed tomography (CT) scans.
  • Electromyography (EMG):This test measures the electrical activity of the skeletal muscles when at rest and during contractions. EMGs are performed with electromyography, which is an instrument that records and graphs this activity.
  • Nerve conduction studies:Sometimes done alongside EMGs, these tests determine whether a nerve is functioning properly.

In all, these diagnostic tests help determine whether symptoms are consistent with cervical radiculopathy or another condition, such as diabetes, which can damage nerves.

Non-Surgical Treatments

As New Jersey’s most comprehensive spine center, CNSO’s personal treatment plans are based on a conservative approach. The award-winning neurosurgeons, spine surgeons, pain management specialists, and physical medicine and rehabilitation physicians collaborate to first consider whether an evidence-based, non-invasive technique would best treat the patient. In most neck pain or cervical radiculopathy cases, patients respond well to non-surgical treatment options, such as:

Rest, With Activity and Lifestyle Modifications

Most patients are advised to prioritize rest, make activity modifications, and form better lifestyle habits to reduce their symptoms. These may include:

  • Use of better form or limiting sports, lifting, and other strenuous activities
  • Maintain a healthy weight through good nutrition
  • Practice better posture when seated or driving
  • Reduce stress
  • Make ergonomic adjustments at work

Physical Therapy and Exercise

A physical therapy regimen often improves symptoms of cervical radiculopathy. Under the direction of a physical therapist, certain exercises and manipulations of the musculature by the physical therapist, can help to improve one’s range of motion, reduce pain, and strengthen muscles. CNSO offers physical therapy services in Wayne, Paramus, Morristown, and Jersey City, NJ.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs are either prescribed or available over the counter at many retail locations and pharmacies. They are recommended for patients who have pain related to nerve inflammation or irritation.

Oral Corticosteroids

These medications aim to reduce inflammation and swelling in the spinal nerves. They usually are prescribed in a short course, over five to seven days, and often are followed by a course of NSAIDs.

Epidural Steroid Injections

To reduce local inflammation, epidural steroid injections are placed within the epidural space, between adjacent vertebrae in the cervical spine. The goal is to decrease swelling and relieve pain, giving the nerve its best chance to recover.

Chiropractic Care and Spinal Manipulation

Through specialized tools or manual therapy, spinal manipulation involves applying pressure to the spine to adjust its alignment. As a result, pressure on compressed nerves is reduced to ease pain and address the underlying cause of cervical radiculopathy.

Acupuncture and Alternative Therapies

Complementary and alternative medicine (CAM) commonly is used in the non-surgical treatment of cervical radiculopathy. For instance, acupuncture aims to relieve pain by inserting thin needles at specific points on the body, stimulating sensory nerves under the skin.

Surgical Options

If cervical radiculopathy does not improve with any one of the conservative treatment options, and if diagnostic imaging has detected a structural cause for the radiculopathy, spine surgery is the next step. CNSO spine surgeons perform every type of surgical procedure proven to treat cervical radiculopathy. These procedures may include:

Anterior Cervical Discectomy and Fusion (ACDF)

Anterior cervical discectomy is the most common surgical option for cervical radiculopathy. Sometimes it is accompanied by a fusion. Using an anterior approach, the neurosurgeon, a spine surgeon, makes a small incision on the anterior side of the neck. Any disc deformity causing nerve impingement is removed, followed by the removal of any bone spurs for the decompression of the affected nerve roots.

The spine is then stabilized by the spine surgeon creating a bone graft to replace the diseased bone, which provides structural support. Pedicle screws or plates fuse the adjacent vertebrae. Some patients may require a spacer made of metal, plastic, or bone, placed between the vertebrae before fusing them. After the surgeon mechanically connects the adjacent vertebrae, the vertebrae should heal as though a single bone, providing more structural spinal stability and less pain.

Cervical Artificial Disc Replacement

After removing the affected disc, spine surgeons replace it with an artificial disc. The implant could be made of metal or a combination of plastic and metal. Cervical artificial disc replacement helps to maintain motion and restore height between vertebrae, as well as makes more room for affected nerve roots to decompress. An anterior approach is used for this procedure, also called a disc arthroplasty.

Microdiscectomy and Minimally Invasive Surgery

CNSO offers microdiscectomy procedures and minimally invasive spine surgery, using advanced medical technology, microscopes, lasers, and other techniques. This technology may be performed both with or without intraoperative imaging or robotics. Microdiscectomy and minimally invasive surgery offer several benefits, such as small incisions requiring few stitches, less bleeding during surgery, shorter recovery times, and less postoperative discomfort.

Posterior Cervical Laminectomy

Using a posterior approach, the spine surgeon makes an incision along the back of the neck for a laminectomy. With a burr and other tools, the lamina is thinned to decompress the impinged nerve. Areas of bone, bone spurs, and tissues are removed if they are compressing the nerve root. If a herniated disc is present, a portion of it will be removed to decompress the nerve.

CNSO’s compassionate neurosurgeons and orthopedic spine surgeons educate patients on their diagnosis, explain the most effective treatment options, and ensure patients understand their expected course toward wellness. This includes discussing the risks and benefits of surgery. CNSO’s spine surgeons inform patients of possible risks, complications, and long-term changes that can come along with a surgical procedure.

Post-Surgery Recovery

After surgery for cervical radiculopathy, patients typically are observed for 3 hours in the facility where the operation occurred. Most patients can eat and walk the first day after surgery, though some experience difficulty swallowing solid foods for a few weeks. Patients also may have a hoarse voice for a short time. To support the neck during healing, patients may be required to wear a soft or rigid cervical collar.

Healing times will vary depending on the type of procedure, how many discs and nerves were affected, and other considerations. It can take anywhere from a few weeks to 1-2 months to fully recover. During the healing period, spine surgeons and the pain management team minimize discomfort with non-surgical treatment options. Physical therapy is also a crucial part of the rehabilitation process. Overall, patients can expect a very gradual return to normal activity levels.

Trust CNSO for Cervical Radiculopathy Care

The dedicated surgical and non-surgical team at CNSO understands how cervical radiculopathy can impact daily life. By working with leading board-certified neurosurgeons, orthopedic spine surgeons, interventional pain management physicians, physiatrists, rehabilitation specialists, and certified physical therapists, patients will receive comprehensive and coordinated treatment for radiculopathy and its causes. CNSO offers multiple convenient locations across northern New Jersey, including Bergen, Passaic, Essex, Morris, and Hudson counties. To learn more about effectively treating cervical radiculopathy pain, contact the medical team at CNSO today.

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