Home / Conditions / Sciatica of the neck
Sciatica is leg pain from a pinched nerve in the lower back. The same thing can happen in the neck, sending pain, numbness or tingling down one arm — and it is easily mistaken for a shoulder or wrist problem.
It is an everyday name, not a medical one, and strictly it is not sciatica: the sciatic nerve runs only in the leg. The name borrows the pattern. In both, a nerve root is squeezed where it leaves the spine, and the pain is felt not at the spine but along wherever that nerve goes.
Doctors call the neck version cervical radiculopathy. It is also what people mean by a pinched nerve in the neck, or neck nerve compression.
| Sciatica | Sciatica of the neck | |
|---|---|---|
| Where the nerve is pinched | Lower back | Neck |
| Where it is felt | Buttock, leg and foot | Shoulder blade, arm and hand |
| Often ends in | Particular toes | Particular fingers |
| Medical name | Lumbar radiculopathy | Cervical radiculopathy |
The pain often starts at the shoulder blade, not the neck. Nerve roots in the lower neck commonly refer pain beside or between the shoulder blades, which is one reason this is taken for a muscle problem. The full finger-by-finger map is on the cervical radiculopathy page.
Two questions go a long way: does moving your neck change it? And does it go past the elbow into the fingers?
| Pinched nerve in the neck | Shoulder problem | Carpal tunnel | |
|---|---|---|---|
| Where it starts | Neck or shoulder blade | Top and outer side of the shoulder | Wrist and hand |
| How far it goes | Past the elbow, often into particular fingers | Upper arm, rarely below the elbow | Thumb, index and middle fingers; can ache up the forearm |
| Numbness or tingling | Common | Not usually | Common, especially at night |
| Worse with | Turning or tilting the head, looking up | Lifting the arm, reaching behind, lying on that side | Gripping, holding a phone, bending the wrist |
| Eased by | Resting the hand on top of the head | Keeping the arm by the side | Shaking or flicking the hand |
These are tendencies, not rules, and a pinched nerve in the neck and carpal tunnel syndrome can be present together. Where it is unclear which, nerve conduction studies help separate the neck from the wrist.
Most pinched nerves in the neck 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 0677Mostly by examination. Strength, reflexes and sensation in the arm are checked against the territory each nerve supplies, which usually points to the level before any scan.
The scan has to match the examination. Disc bulges and narrowing are common in people with no symptoms at all, so a finding on MRI only counts if it sits at the level your arm points to.
Most settle without an operation, usually over weeks to a few months.
Anti-inflammatories help some people; medicines aimed specifically at nerve pain often help more. Keep moving within comfort rather than resting the neck for long.
Posture, targeted movement and sometimes traction to take pressure off the nerve, once the worst of the pain allows.
A cervical epidural injection around the affected root can settle the inflammation enough for rehabilitation to work. It is one of Dr Tung’s procedures.
Considered where weakness is significant or getting worse, or where pain has not settled after a proper course of treatment. The options — widening the nerve’s opening, removing the disc with fusion, or disc replacement — are compared on the cervical radiculopathy page.
For a pinched nerve in the neck, either is appropriate. The nerve is what hurts; the disc or bone spur pressing on it is the cause. The two surgeons come at the same problem from each end.
Arm pain, numbness and weakness, and the question of whether the neck, the wrist or the spinal cord is responsible.
A neurosurgeon trains on the nervous system first. Dr Mathew Tung also treats carpal tunnel syndrome, and offers cervical epidural injections, nerve root blocks, foraminotomy and disc replacement.
The disc, the bone spurs, and the wear in the neck that puts the nerve under pressure.
An orthopaedic spine surgeon trains on the musculoskeletal system first. Dr Lim Heng Hing’s spine work centres on slipped discs, spinal stenosis and neck pain, with interventional pain treatment — radiofrequency ablation and intradiscal therapy — for chronic neck pain before any open operation.
You do not need to pick correctly. Either is a sound first appointment, and having both surgeons in one clinic means the answer is not shaped by whichever one you happened to book. If the other approach fits better, that is a conversation down the corridor rather than a new referral.
More on how the two differ: neuro spine and orthopaedic spine surgery.
Not strictly. The sciatic nerve is in the leg. The name describes the same kind of problem — a pinched nerve root — one region up, in the neck.
Yes. Cervical radiculopathy is the medical name, and a pinched nerve in the neck is another everyday one.
Nerve roots in the lower neck commonly refer pain beside or between the shoulder blades. It is often the first place people feel it, before the arm.
Often. Most people improve over weeks to a few months with medication, physiotherapy and time. Weakness that is getting worse is the exception, and should be seen promptly.
It is best avoided until the cause has been assessed. With nerve symptoms in the arm, the first step is knowing what is pressing on the nerve, and whether the spinal cord is involved too.
No. Bring any MRI or X-ray reports, and note which fingers are affected and which movements make it worse.
Cervical radiculopathy · Sciatica · Neck pain · Cervical spondylosis · Slipped disc · Cervical myelopathy · Carpal tunnel syndrome · Shoulder pain
If you can say which fingers are affected, tell us when you book. It is the most useful single detail.
