Causes of Cervical Radiculopathy

Causes of Cervical Radiculopathy

Depiction of narrowing of spinal spaces and irritation of spinal nerve root
Narrowing of spinal spaces and irritation of spinal nerve root. BSIP/UIG/Universal Images Group/Getty Images

Causes of Cervical Radiculopathy

If you get pain and/or pins and needles down your arm, your doctor may diagnose you with cervical radiculopathy. 

Cervical radiculopathy is a syndrome (i.e., a collection of signs and symptoms) that expresses as pain and/or sensorimotor functioning defects, and that is due to a compressed spinal nerve root. 

Related: Spinal Nerve Root

Symptoms that typically alert doctors to the need for further diagnostic testing for cervical radiculopathy include: Arm pain, neck pain, scapular or periscapular pain (scapular refers to your triangularly-shaped shoulder blade bone, which is located on your upper back), and paresthesias (a pins and needles sensation) numbness, weakness, sensory changes or abnormal deep tendon reflexes in the arm.

Two spinal conditions are responsible for most cases of cervical radiculopathy.  This article discusses each of these causes.  Slide on to learn more.

Disc Herniation and Cervical Radiculopathy

Depiction of a herniated disc
Depiction of a herniated disc. Medical Art Inc/E+/Getty Images

Disc Herniation and Cervical Radiculopathy

Disc herniation, whether acute or chronic, is another common cause of cervical radiculopathy. Acute disc herniation usually occurs in younger people who still have a fair amount water inside the nucleus pulposus of the disc.  Acute disc herniations tend to be brought on by injury or trauma to the spine and quite often cause a lot of severe pain and other symptoms. 

Learn more about acute disc herniation.

Chronic disc herniations, on the other hand, may occur upon the drying out and degeneration of the disc.  A chronic disc herniation collapses the disc space, resulting in a decrease in the height of the disc.  A fragment of the disc then exudes through a tear or defect in the annulus fibrosis.  (The annulus fibrosis is the tough outer covering around an intervertebral disc that normally seals and contains the softer inner core, or nucleus pulposus.) If the chronic disc herniation compresses the spinal nerve, which it usually does, it can cause cervical radiculopathy symptoms.

According to the website, the diagnostic code for cervical radiculopathy is:  2015/16 ICD-10-CM Diagnosis Code M47.22  - Other spondylosis with radiculopathy, cervical region.

Facet Joint Spondylosis and Cervical Radiculopathy

Depiction of a spine with spondylosis and facet joint hypertrophy
Facet joint hypertrophy may cause radiculopathy symptoms. Medical Art Inc./E+/Getty Images

Facet Joint Spondylosis and Cervical Radiculopathy

Facet joint spondylosis is a term that refers to degenerative changes in your facet joints, which includes arthritic changes.  Facet joint spondylosis that results in cervical radiculopathy is often caused by increased loading onto the spinal column when degenerating discs lose their height in front.

But another way to understand the role of facet joint spondylosis in cervical radiculopathy symptoms is to view it in terms of spinal arthritis.

Through injury, trauma, or disease that affect joints (such as rheumatoid arthritis,) the facet joint may become loose.  According to Caridi, Pumberger and Hughes, in their 2011 review entitled “Cervical Radiculopathy: A Review," published in the Hospital for Special Surgery Journal, the extra movement (hypermobility) leads to hypertrophy - which means "getting bigger" and is also known as spondylosis -  of the surrounding spinal ligaments (namely, the posterior longitudinal ligament or PLL, and ligamentum flavum.)  The hypermobility also leads to hypertrophy of the vertebral bones. 

In particular, the authors say, as the superior articular process – which is the top part of one facet joint - gets bigger, it can compress the spinal nerve root, causing symptoms of radiculopathy.  Note that facets are located on either side of the spine, and that this compression may affect one or both of these joints.

Learn More About Facet Joint Hypertrophy

However you understand it, because facet joint spondylosis is a degenerative condition, it develops over time rather than suddenly, and its onset is gradual and insidious.

By the way, cervical radiculopathy is one of three categories associated with spondylosis.  The other two are neck pain that stays in the neck, and myelopathy, or symptoms related to spinal cord irritation.

Cervical Radiculopathy Sources

Architectural view of a big library with lots of books.
Architectural view of a big library with lots of books. Carl Bruemmer / Design Pics/Perspective/Getty Images

Cervical Radiculopathy Sources

Caridi, John, M., M.D.,  Pumberger, Matthais, M.D. Hughes, Alexander, P., M.D.  Cervical Radiculopathy: A Review.  Hospital for Special Surgery Journal. 2011.

Ferrara, Lisa A., Review Article, The Biomechanics of Cervical Spondylosis. Advances in Orthopedics Volume 2012. Hindawi Publishing Corporation. Accessed November 2015.

Mullin, Jeffrey, Shedid, Daniel, Benzel, Edward. Overview of Cervical Spondylosis Pathophysicology and Biomechanics. World Spinal Column Journal. September 2011.

Spondylosis M47. Accessed November 2015.

NAAS Evidence Based Guideline Development Committee. Diagnosis and Treatment of Cervical Radiculopathy from Degenerative Disorders.  North American Spine Society.  2010. Burr Ridge, IL.

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