By Dr. John A. Papa,
DC, FCCPOR(C)
About two-thirds of
people will experience neck pain at some point in their lives. Occasionally, neck pain can spread to involve
other structures such as the upper back, shoulder, and arm regions. Pain in these regions is often dismissed
simply as muscle pain. However, a “pinched
nerve” originating from the neck can radiate pain to these nearby anatomical
sites and be a significant source of discomfort.
The “cervical spine” is
the medical name given to the region of the neck. Nerve roots originate from the cervical spine
on each side. These nerves send off
various branches that travel to distinct regions in the upper back and arms to
supply strength to muscles and provide sensation/feeling. The term “pinched nerve” is often
used to describe a mechanical and/or inflammatory irritation directly affecting
any component of the nerve root(s) in the neck/cervical spine.
A “pinched
nerve” in the neck can cause symptoms almost anywhere along the nerve
pathway. This may result in neck symptoms
only, and/or symptoms that radiate into the chest, upper back, shoulder, arm,
hand and finger regions. The symptoms
can vary widely and may include: a
cramping or achy feeling, tightness, burning or a sharp electric shock
sensation, numbness, tingling, and arm muscle weakness. The symptoms may start gradually and
intensify over time. Activities such as
movement of the neck or shoulder, prolonged sitting or laying down, lifting, and
even coughing or sneezing may aggravate the symptoms.
Below is a brief
summary of three common causes of a "pinched nerve" in the neck:
1. Spinal
disc herniation/bulge – Spinal discs separate and cushion cervical
vertebra. Repetitive and cumulative
loads or a heavy single load has the potential to cause a disc bulge or
herniation, thereby causing a mechanical and/or inflammatory irritation of the
nerve root(s). This most commonly occurs
in adults aged 20-50.
2. Degeneration
and Osteoarthritis – The normal aging process causes cervical disc
degeneration and osteoarthritis of the cervical joints. The consequence of these processes is that
mechanical irritation from bony spurs on the vertebrae along with inflammation
can cause irritation of the nerve root(s).
This most commonly occurs in adults over 50.
3. Cervical
spinal stenosis – This condition may cause “pinched
nerve” symptoms due to narrowing of the spinal canal and/or nerve
pathways, which puts pressure on the nerve root(s) or spinal cord. This most commonly occurs in adults over
60. It is usually secondary to degeneration
and osteoarthritis.
Other causes of a “pinched
nerve” in the neck include: direct irritation of nerve tissue by
overlying muscles; direct trauma or injury to the nerve root(s); and mechanical
changes in the neck associated with poor postural habits (i.e. head poking
forward in the sitting position). Some
common causes of symptoms that act like a “pinched nerve” in the neck include
muscular trigger points, ligament sprains and arthritic joints from the neck,
upper back, and shoulder regions.
Treatment for a “pinched
nerve” in the neck will often be different depending on the underlying
cause of the symptoms. Therefore, it is
important to obtain an accurate diagnosis.
A proper medical history, along with physical examination consisting of
range of motion, strength, neurological and orthopaedic testing, along with
diagnostic imaging (if necessary) should be performed to aid in the
diagnosis. It is extremely important to
rule out rare causes of “pinched nerve” symptoms such as spinal
tumors, fractures and infections. Disorders
of the esophagus, trachea (windpipe), heart and thyroid can cause symptoms that
overlap with those of a “pinched nerve” in the neck. These potential causes require appropriate
medical referral when applicable.
There are natural and
conservative treatment options available for those suffering from a "pinched
nerve" in the neck. These
may include: mechanical traction, spinal manipulation and mobilization, soft
tissue techniques, acupuncture, ice/heat application, electrotherapy, activity
modification, postural education, and rehabilitative exercise. A qualified health professional can determine
the cause of your symptoms and prescribe appropriate therapy and rehabilitation
strategies specifically for your circumstance.
For more information, visit www.nhwc.ca.
This article is a basic summary for educational purposes
only. It is not intended, and should not
be considered, as a replacement for consultation, diagnosis or treatment by a
duly licensed health practitioner.
