Cervical Radiculopathy
What is it: Cervical radiculopathy symptoms are caused by compression of a cervical nerve root by a herniated disc (or facet), or by uncovertebral joint arthritis of the cervical spine.
How does it present: Patients may experience shoulder pain, but often have additional pain that radiates from the neck down the arm. They may complain of only pain or may have paresthesias and weakness. Symptoms often worsen with specific neck motions.
Common exam findings: You may find that symptoms increase with range of motion of the neck or on a Spurling's Test, and the range of motion may be limited. It is important to perform and document a thorough neurological exam of the upper extremities to evaluate for any weakness, decreased sensation, or reflex changes.
Tests and treatment: In the absence of neurologic changes you may consider treating conservatively as most symptoms will improve over time. Physical therapy may be considered as well. In the acute setting, a short course of oral steroids could be considered. If neurologic changes are present, you may need to consider cervical x-rays, MRI, or EMG to further evaluate the need for surgical or other interventional treatment needs.