Understanding Nerve Impingement in the Neck: Causes, Symptoms, and Treatment

In a recent OrthoCarolina webinar, Dr. Barchick, a spine specialist, shared insights on nerve impingement in the neck, also known as cervical radiculopathy. This condition, often referred to as a pinched nerve, can cause pain, numbness, and weakness that radiates from the neck into the shoulders, arms, and hands. 

What Is Cervical Radiculopathy?

Cervical radiculopathy occurs when a nerve root in the cervical spine becomes compressed or irritated. The cervical spine, or neck region, is composed of vertebrae with nerves branching out between them. These nerves travel through the brachial plexus in the chest and upper arm, eventually extending into the forearm and hand. When one of these nerve roots is pinched, it can disrupt normal nerve signaling, leading to pain, tingling, numbness, and muscle weakness on one side of the body.

Symptoms can vary widely. Some patients experience mild discomfort, while others suffer from severe, radiating pain. Weakness in specific muscles may also occur, affecting grip strength or arm movement. Less commonly, patients might notice sharp pains in the neck or head, which can mimic other conditions.

Causes of Nerve Impingement

Several factors can lead to cervical radiculopathy. The most common include:

• Disc herniation: Soft tissue from the intervertebral disc can protrude and press against a nerve root, causing pain and inflammation.
• Bone spurs or arthritis: Changes in bony anatomy can narrow the spaces where nerves exit, leading to compression.
• Alignment issues: Conditions such as cervical kyphosis, a forward curvature of the neck, can affect nerve function.
• Posture and ergonomics: Prolonged computer use or poor posture may exacerbate symptoms or mimic nerve impingement, though they are not typically the sole cause.

It is important to note that similar symptoms can arise from other conditions, including peripheral nerve issues like carpal tunnel or cubital tunnel syndrome, shoulder injuries such as rotator cuff tears, or muscular problems. Accurate diagnosis is essential for effective treatment.

Diagnosis and Evaluation

Physicians begin by gathering a detailed clinical history, focusing on the onset, location, and severity of symptoms. A thorough physical exam helps assess patterns of pain, tingling, numbness, and weakness. Differentiating cervical radiculopathy from other musculoskeletal or neurological conditions is critical.

This combination of history, examination, and imaging allows physicians to create an individualized treatment plan that targets the underlying cause of nerve compression.

Non-Surgical Treatment Options

Many cases of cervical radiculopathy improve without surgery. Non-operative strategies focus on reducing inflammation, relieving pain, and restoring function. Common approaches include:

• Physical therapy: Stretching, strengthening, and posture correction can stabilize the neck and relieve pressure on nerve roots.
• Medications: Non-steroidal anti-inflammatory drugs, muscle relaxants, and nerve-specific pain medications can help manage symptoms.
• Occupational therapy and ergonomic adjustments: Evaluating and modifying daily activities, workstations, or posture can prevent further strain.
• Injections: Precision injections delivered by interventional spine specialists can reduce inflammation and alleviate pain in targeted areas.

Conservative treatment is often the first step, with progress monitored over weeks or months. Many patients achieve significant relief and functional improvement through these measures.

When Surgery Is Considered

Surgery may be recommended when non-surgical approaches do not provide relief, or when patients experience significant weakness or signs of spinal cord compression. Common procedures include:

• Anterior cervical discectomy and fusion (ACDF): Removal of the problematic disc, followed by stabilization with a device and plate to encourage fusion.
• Cervical disc replacement: Replaces a damaged disc with an artificial one to maintain motion at the affected level.
• Microforaminotomy or laminoplasty: Minimally invasive procedures that relieve nerve compression by enlarging the space where nerves exit the spine.

Recovery varies depending on the procedure and individual health factors. Outpatient surgeries allow many patients to return home the same day, followed by a period of activity modification, pain management, and physical therapy. Most patients experience notable relief from pain and improvement in function when the correct issue is addressed.

Recovery and Preventing Recurrence

Recovery from cervical radiculopathy depends on the severity and cause of nerve impingement. Soft tissue injuries may resolve fully, whereas bony changes may require ongoing monitoring. Physical therapy, proper posture, and ergonomic adjustments can reduce the risk of recurrence. Patients are encouraged to maintain neck strength and flexibility, avoid extreme positions that place pressure on discs or joints, and seek evaluation promptly if symptoms worsen.

Lifestyle factors, such as workstation setup, daily movement habits, and exercise routines, play an important role in long-term neck health. Early intervention for new or worsening symptoms helps prevent progression and supports optimal recovery.

Collaborative Care and Expertise

Management of cervical radiculopathy benefits from a team-based approach. At OrthoCarolina, spine specialists and interventional physicians collaborate to ensure patients receive precise diagnosis and tailored treatment plans. Participation in research and professional societies allows physicians to stay at the forefront of spinal care, integrating the latest evidence-based practices into patient management.

This collaborative, patient-focused approach ensures that individuals receive comprehensive care, whether their path involves non-surgical management, injections, or surgery.

Taking Action

If you experience persistent neck pain, tingling, numbness, or weakness in your arms or hands, it is important to seek evaluation from a qualified spine specialist. Early diagnosis and targeted treatment increase the likelihood of a successful recovery and can help prevent long-term complications.

OrthoCarolina’s Spine Center provides personalized care for cervical radiculopathy, offering advanced imaging, non-surgical interventions, and surgical options when needed. Schedule a consultation or walk-in today to address your symptoms and regain comfort and function.

Frequently Asked Questions

Can nerve impingement in the neck heal without surgery?

Yes, many cases improve with time, physical therapy, medications, ergonomic adjustments, and, in some cases, precision injections. Surgery is only recommended if symptoms persist or worsen.

How long does recovery take after cervical spine surgery?

Recovery varies based on the procedure and individual health factors. Many patients can return home the same day for outpatient procedures and gradually resume activities over several weeks with guidance from their physician.

Can lifestyle changes prevent future nerve impingement?

Yes. Maintaining proper posture, optimizing ergonomics, performing neck-strengthening exercises, and avoiding extreme neck positions can reduce the risk of recurrence and support long-term spinal health.