Pinched nerve or cervical radiculopathy is a condition in which the nerve gets pressurized between a pair of spinal disc or cartilage causing immense pain. A cervical spine or the neck is made up of vertebras and the nerves exit from these vertebras. So when a vertebra is displaced it traps a nerve root that exits the spinal column, which stops the functions of the nerve causing inflammation and pain. A human neck, being flexible, is more prone to a disc prolapse or herniated disc which causes cervical compressed nerves.
Some important and common causes are bad posture and degeneration of bones due to age. As the bones age it loses its height and water content, as a result it gets weak and starts to bulge, which in turn brings the vertebras closer to each other. Under this circumstances the nerve roots gets compressed and problems begin. As these nerve roots do not have any protective covering, there is always an increased chance of injury in this area, especially the sixth and the seventh cervical nerve root. Other causes are manual labor, smoking, and tumor of the spine, spinal infection or arthritis.
Pain in neck or cervical region is among the first symptoms that appear. It is followed by numbness, pain radiating to the shoulders and arms, spasm, etc. There is also an increased chance of temporary but very disturbing headache or a tingling sensation. Headaches normally occur in the retro-orbital region that is right behind the eyes. In a few cases it is noticed that the pain does not occur at the host place but it travels to another region of the body, this is called ‘referred pain’. For example – a pinched nerve at the C6 nerve root may cause pain to the thumb & index finger of one or both the arms.
As cervical radiculopathy is the neurological condition, a through physical examination by the doctor is a must. Spurling’s Test, Shoulder Abduction Test, Neck Distraction Test, Upper Limb Tension Test are a few ways that a doctor uses to detect the pinched nerve in neck and its location. This helps in understanding the strength, sensation and reflexes of the neck. Other tests include x-rays, MRI, needle electromyography or NCV (Nerve conduction velocity) test. Myelography is another method to detect the problem as it gives good images of the soft tissues and extent of the disc protrusion.
Holistic treatment, conservative method or non surgical ways, whatever they may be called, but it is the best method to treat a pinched nerve. The very first step is to give the region ample rest and cold and hot compression. In most cases doctors ask the patients to use a neck collar or cervical brace to immobilize the area. This diminishes the inflammation of the irate nerve and also acts as a hot pack which produces heat that gives therapeutic effect to the area. Another way is to give traction, as this separates the bones, thus reliving the nerve of its trauma. In very mild cases neck exercise, ointment and a neck pillow is useful.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are given for instant relief from pain and inflammation. A note of caution is that long term use of these drugs can have very adverse effects on the liver and kidney. Though only relying on the dugs is not enough as they only give relief for a period of time. Then as the effect starts to wain the pain is back. Thus ultrasound, electrical stimulation or physiotherapy, and therapeutic exercises are a necessity for pinched nerve, but only with the help of a professional or chiropractic. Chiropractic not only addresses the symptoms but also the route cause, further they can guide in a very systematic way to improve the body posture.
When response to medication, traction and exercise is not satisfactory then spinal steroid injections are given. Many studies have shown improvement after this form of treatment, when other have failed to provide results. Though complications like spinal cord or root injury, intraocular hemorrhage from this procedure are rare, but if it occurs they can be catastrophic. Single root legion respond best to these injections. As alternate to this procedure is acupuncture, which has provided relief too many ailing patients. The last resort to treat a pinched nerve is surgery, which does provide long term relief, with side effects. A note of advice would be that stress, anxiety and worry are the greatest barriers in treating any problem.