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Tests for Cervical Radiculopathy

Neck pain is caused by conditions such as degenerative disk disease (when the disks between the vertebrae lose water and collapse), bone spurs and pinched nerves. Cervical radiculopathy is a term that describes pinched nerves that cause pain to radiate into the neck, shoulders and arms.

  1. Features

    • Degenerated disks cause the spaces between the vertebrae to narrow, which irritates the spinal joints, causing them to enlarge and press against the nerves going to the arms and shoulders. Disk collapse also causes bone spurs (bony growths from the vertebrae) that puts pressure on nerves and produces pain.

    Symptoms

    • Disk degeneration can begin around 50 years of age. Depending on which cervical spine nerves are pinched, a patient may have upper limb and shoulder pain, numbness and tingling in the arms and hands or weakness of the upper extremities.

    Nerve Roots

    • The most common locations of cervical radiculopathy pain are the C5, C6, C7 and C8 nerve roots (end of nerves where they exit the spinal cord). The pain can present in a combination of places in the neck, arms, shoulders and fingers.

    Physical Examination

    • A patient has a complete physical examination and describe the symptoms to the doctor. The doctor will observe the way the patient moves and carries the neck, shoulders and upper limbs. The doctor will perform a combination of range-of-motion, sensory, reflex, strength, provocative (to reproduce symptoms) and instability testing (to see if the neck joints are unable to carry weight).

    Orthopedic Testing

    • There are numerous orthopedic tests that a doctor can perform to check for cervical radiculopathy. Spurling's sign, one of the most common tests, is positive if pain is present when the patient extends the neck and there is pain on turning the head. The axial compression test is positive if pain is present when the doctor presses down on the patient's head with the neck in a straightened position.

    Imaging Studies

    • X-rays are used to diagnose narrowing of disk spaces and bone spurs. CT scans (X-ray technology combined with computer imaging) are used to visualize the bones of the spine to diagnose irregularities. MRI (three-dimensional image produced by electrons) scans are used to diagnose soft tissue irregularities like ligament and disk abnormalities.

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