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Many people will suffer with neck pain at some point in their adult life
Many people will suffer with neck pain at some point in their adult life. A small percentage will experience pressure on the nerve root adjacent to the disc.
This nerve root pressure results in the severe pain radiating down the arm.
90% will resolve without specialist input and more than 70% report improvements in their symptoms within 4 weeks
There may be sensory symptoms such pins and needles, tingling or numbness in the arms or hands and in rare cases individuals develop some weakness to particular muscle groups in the upper limb.
Commonly, symptoms tend to be aggravated with sitting postures, especially with prolonged work at a computer and in the morning after sleeping.
Symptoms are often relieved with simple exercises, postural or ergonomic modifications and maintaining general levels of activity.
The main feature on examination is often a reduced range of movement and the reproduction of shoulder and arm symptoms when extending the neck.
Sensation, power and reflexes will also be assessed. X-rays are not required.
Scans are not routinely required, but may be requested if injections or surgery are being considered.
In the majority of cases, neck and nerve root pain can be managed effectively by non-invasive measures as described below. The most effective are exercises, ergonomic modifications and in those who are sedentary, maintaining general activity levels.
Exercises can relieve stiffness in the spine and maintain flexibility at the shoulders
Modifications could include raising your seat height, changing the backrest angle, lumbar wedges as well as ensuring there is an appropriate overall set up if working with display screen equipment. Everyone is different, so try out slightly different combinations which may work best for you
It is reasonable to try over the counter painkillers initially. Unfortunately, standard painkillers are not very effective in relieving radicular pain from nerve root compression. Your clinician will advise on medication that may help your symptoms. This may include muscle relaxants and anti-neuralgic medications.
For individuals who continue to suffer symptoms significantly affect their quality of life and who have undergone scans confirming the presence of nerve root irritation, an injection around the nerve root may be offered.
Decompression surgery for the affected nerve root can be offered for patients who: