Cervical Radiculopathy / Arm Pain

Cervical radiculopathy, often referred to as a “pinched nerve,” occurs when a nerve in the neck becomes compressed or irritated.
This irritation can lead to pain, tingling, numbness, or weakness that radiates from the neck into the shoulder, arm, or hand.

It is one of the most common causes of arm pain, and with early diagnosis, most patients can find relief through non-surgical care.

Cervical radiculopathy happens when something presses on or inflames a cervical nerve root as it exits the spinal canal.
Common causes include:

• Herniated disc – the soft center of a spinal disc bulges out, pressing on a nerve root.
• Bone spurs (arthritis) – overgrowth of bone from degenerative changes narrows the space around the nerve.
• Degenerative disc disease – age-related disc wear reduces space between vertebrae, leading to nerve compression.
• Cervical spinal stenosis – narrowing of the spinal canal, especially in older adults.
• Trauma or injury – whiplash, falls, or sports injuries can shift spinal structures.
• Poor posture or repetitive strain – long-term stress on the neck, such as from computer or phone use (“tech neck”).

Cervical radiculopathy symptoms usually follow the path of the affected nerve into the arm or hand.

• Neck pain that may be sharp, aching, or stiff
• Radiating arm pain – burning, shooting, or electric-like pain traveling down the shoulder, arm, or into the hand or fingers.
• Numbness or tingling (“pins and needles”) in the arm, hand, or fingers.
• Muscle weakness – trouble performing fine motor tasks.
• Worsening symptoms with certain movements, such as turning the head, looking up, or prolonged sitting.

Urgent signs: sudden or severe weakness, or changes in balance, coordination, or bladder/bowel control — these require immediate medical attention.

Dr. Fried uses a step-by-step approach to accurately diagnose cervical radiculopathy:

• Medical history: review of symptoms, daily activities, and potential injury history.
• Physical examination: evaluation of neck mobility, strength, reflexes, and sensation to identify which nerve is involved.
• Imaging studies:
  • X-rays: assess alignment and degenerative changes. 
  • MRI: best for visualizing nerve compression and soft tissues.
  • CT scans or nerve studies (EMG/NCV): used for complex or unclear cases.
     

Most patients improve with non-surgical care, especially if symptoms are mild to moderate.
Surgery is considered if conservative treatments fail or if there is progressive weakness or severe nerve compression.