Home / Conditions / Cervical radiculopathy
A nerve root compressed where it leaves the neck, sending pain, numbness or weakness down one arm. Which fingers it reaches tells you which nerve is involved — and most settle without surgery.
Eight pairs of nerve roots leave the spinal cord through small openings between the vertebrae of the neck and travel down into the shoulders, arms and hands. Cervical radiculopathy is what happens when one of those openings narrows and squeezes the root passing through it.
The result is felt not in the neck but along wherever that nerve goes — which is why the pain runs down an arm and often ends in specific fingers. It is also why people frequently arrive convinced the problem is in their shoulder or elbow.
The commonest causes are a disc herniation pressing on the root, or the bone spurs and narrowing that come with cervical spondylosis. Younger people tend to get the disc version; older people the bony one.
This is the most useful thing on the page. Each root supplies a defined territory, so where the symptoms end says a great deal about which level is affected — often before any scan.
| Nerve root | Pain and numbness reach | Weakness shows as |
|---|---|---|
| C5 | Shoulder and upper outer arm | Lifting the arm out to the side |
| C6 | Outer forearm, thumb and index finger | Bending the elbow, bending the wrist back |
| C7 | Back of the arm, middle finger | Straightening the elbow, pushing |
| C8 | Inner forearm, ring and little finger | Grip, finger movements |
| T1 | Inner upper arm | Spreading the fingers |
C6 and C7 account for most cases. If you can say which fingers are affected, you have already given the most informative piece of the history.
This is the C6 pattern in one picture. The disc between the fifth and sixth vertebrae has herniated, the root leaving at that level is caught, and the pain follows that nerve — down the outer arm and into the thumb and index finger.
Nothing is wrong with the arm. The arm is simply where the nerve ends up, which is why people so often have it examined before anyone looks at the neck.
Change the level and the picture moves. A C7 root lights up the back of the arm and the middle finger; a C8 root the inner forearm and the little finger. The glow follows the nerve, and so do your symptoms.
One sign worth knowing about. Many people with cervical radiculopathy find the arm pain eases when they rest the affected hand on top of their head. That seems counter-intuitive, but lifting the arm takes tension off the compressed root. If you have found yourself doing this without thinking about it, mention it — it points quite specifically to a nerve root problem.
Both come from wear in the neck, and both can exist together. They are not equally serious.
| Radiculopathy | Myelopathy | |
|---|---|---|
| What is compressed | One nerve root | The spinal cord |
| Typical symptom | Pain down one arm | Clumsy hands, unsteady walking |
| Pain | Usually prominent | Often absent |
| Sides | Usually one | Often both |
| Natural course | Frequently improves on its own | Tends to progress |
If you also notice clumsy hands, trouble with buttons, or that your walking has become unsteady, say so. Those point towards the cord rather than a root, and that changes the urgency considerably.
Most cervical radiculopathy can be assessed in the ordinary course of things. These cannot:
Call us on +65 8849 0677. We will see you the same day and arrange imaging if it is needed.
If we are closed, go to an emergency department — we are shut on Sundays and after 1pm on Saturdays.
Call +65 8849 0677Largely by examination. The distribution of the symptoms, the pattern of weakness and the reflexes together usually identify the level before any imaging.
A scan alone does not make this diagnosis. Disc bulges and narrowing are common findings in people with no symptoms, so what matters is whether the level on the scan matches the level your examination points to.
The important context first: most cases improve without surgery. That is worth knowing before reading a list that ends in operations.
Anti-inflammatories, and briefly a muscle relaxant where spasm is limiting. Ordinary painkillers work less well here than for mechanical neck pain, because this is nerve pain — and medication aimed at nerves often helps more.
Targeted movement, posture correction and sometimes traction to open the space the nerve passes through. More useful once the acute pain has eased enough to allow it, which is where medication earns its place.
An image-guided injection around the affected root can reduce inflammation enough to break the cycle and allow rehabilitation. It also confirms the level: if the right root was treated, the response tells you so. Cervical epidural injections are among Dr Tung's procedures.
Considered where weakness is significant or progressing, where pain has not settled after a proper course of conservative treatment, or where imaging shows compression that is not going to resolve.
All are performed here. Which fits depends on where the compression is and whether one level or several are involved.
Arm pain has several possible sources, and the most useful thing an assessment does is establish which one you have before anything is treated.
Yes — cervical radiculopathy is the medical term for it. You may also see it described as sciatica of the neck, because the mechanism is the same as sciatica in the leg, just higher up.
Most do. The large majority of people improve with conservative treatment over weeks to a few months. Surgery becomes the question where weakness is significant, or where pain persists despite proper treatment.
Because the nerve is compressed at the neck but travels to the hand. The symptoms appear along the nerve's whole course, which is why the affected fingers indicate which level is involved.
Lifting the arm reduces tension on the compressed nerve root. It is a recognised sign, and a useful one to mention — it points fairly specifically to a root problem rather than a shoulder one.
Not on its own. Disc bulges appear on scans of people with no symptoms at all. What matters is whether the level shown matches your examination and whether conservative treatment has been given a fair trial.
No. Bring any imaging, and note which fingers are affected, what positions make it better or worse, and whether you have noticed any clumsiness or unsteadiness.
Cervical myelopathy · Cervical spondylosis · Sciatica of the neck · Neck pain · Slipped disc · Carpal tunnel syndrome · Neuropathic pain
Arm pain, numbness or weakness coming from the neck is worth having examined properly — the level is usually identifiable before any scan.
