Our backbone (technically referred to as the vertebral column) consists of a series of bony elements known as the vertebrae. Through the centre of the vertebral column runs an empty canal known as the vertebral canal. This vertebral canal houses the spinal cord, from which nerves emanate at various levels.
The first seven vertebrae in our vertebral column are known as the cervical vertebrae or the neck vertebrae. The portion of the spinal cord that is surrounded by the cervical vertebrae is known as the cervical spine. Eight cervical nerves emanate from this part of the spinal cord.
The vertebrae are separated from each other by a structure known as the intervertebral disc. The intervertebral discs are made up of a soft, gelatinous central part that is surrounded by a tough outer layer. These intervertebral discs allow the movement of the vertebrae and also act as shock absorbers.
The spinal nerves exit through holes that exist between the consecutive vertebrae. In the cervical region, eight cervical nerves exit the spinal cord through the spaces between the cervical vertebrae. These cervical nerves supply areas of the head, neck, shoulders and arms.
What is a pinched cervical nerve?
In some cases, a cervical nerve may get compressed (pinched nerve) as it leaves the spinal cord in the neck region. This nerve compression may occur due to hernia of an intervertebral disc in the neck region, pressure from the bony spurs of the cervical vertebrae, narrowing of the spinal canal (technically known as spinal stenosis), or a degeneration of the intervertebral discs. This condition of a pinched nerve in the neck region is technically referred to as cervical radiculopathy. Numbness, tingling and pain in the shoulders, arms and hands may result from a pinched neck nerve.
Read more on pinched upper back nerve.
Signs and Symptoms
A pinched neck nerve produces signs and symptoms in the neck, shoulders, arms and hands. The following are some of the signs and symptoms that may indicate a pinched neck nerve:
- A tingling sensation that may be described as a sharp “pins-and-needles” sensation may occur in the areas supplied by the affected nerve like the arms.
- Pain may occur in the areas (head, neck, shoulders, arms, hands) that are normally innervated by the pinched nerve.
- The areas innervated by the pinched nerve may either show diminished sensation or numbness.
- A burning sensation may occur in the areas supplied by the affected nerve.
- The muscles innervated by the pinched nerve may become weak, causing movements to be weak. Muscle wasting in the affected areas may also be observed.
- Neck stiffness and pain may also occur.
- Dizziness and difficulty walking may occur in some cases.
- Uncoordinated movements and abnormal reflexes may be present.
Read more on upper arm pain.
Causes of Pinched Neck Nerve
The following are some of the potential causes of a pinched or compressed cervical nerve:
Hernia of intervertebral disc
Hernia refers to an abnormal protrusion of a tissue or an organ into a body space where it is not normally located. Herniation of an intervertebral disc occurs when the tough outer layer of the intervertebral disc ruptures, resulting in a protrusion of the soft gelatinous disc into the spinal canal. This protruding disc can compress the surrounding spinal nerves, leading to signs and symptoms of a pinched nerve.
Degeneration of intervertebral disc
Break down or degeneration of intervertebral discs due to a degenerative disc disease is another potential cause of pinched neck nerves. The degeneration of intervertebral discs is also accompanied by a thickening of the bony vertebrae that may compress the spinal nerves.
Bony spurs refer to abnormal outgrowths of the bone into the spinal canal. Bony spurs may occur in conditions such as osteoarthritis. These bony spurs may compress the nerve roots, resulting in cervical nerve compression.
Spinal stenosis refers to a narrowing of the spinal canal. This compresses the spinal cord and may cause pinched neck nerves. Spinal stenosis is a feature of many conditions such as herniated discs, osteoarthritis, tumors in the spinal canal, spinal cord injury, and Paget’s disease.
Excessive flexion curvature of the spine in the cervical region is referred to as kyphosis. In some cases, this deformation of the spine may result in compression of the cervical nerves.
Injury to the spinal cord
Falls or vehicular accidents are common reasons for spinal cord or vertebral column injuries. Fractures of the vertebrae and other soft tissue damage in the cervical region may impinge on the cervical nerves, leading to pinched cervical nerves.
A growing tumor within the spinal canal or near the spinal cord in the neck region can compress the cervical nerves.
Compression of cervical nerves may also occur due to the presence of an abscess, which refers to an accumulation of pus and blood.
Cervical dystonia refers to a condition in which there is a prolonged, involuntary contraction of the neck muscles. Also known as spasmodic torticollis, cervical dystonia is a rare condition that affects mostly middle-aged women. The involuntary contraction of the neck muscles may lead to compression of the nerves in the neck. The compression of the cervical nerve in cervical dystonia may be severe enough to cause permanent nerve damage.
Cervical spondylosis (also known as cervical osteoarthritis) is a progressively worsening degeneration of the bones and cartilages of the vertebral column. This condition usually affects people over the age of 40 years, and can lead to the formation of bony spurs that compress the cervical nerves. This condition is thought to be due to progressive “wear-and-tear” associated with aging. Both men and women are equally likely to be affected.
Diagnosis of Pinched Neck Nerve
Diagnosis of a pinched or compressed cervical nerve is based on the patient’s clinical history, physical examination and other tests. The range of motion of the neck may be determined using the neck flexibility assessment, which involves determination of the extent of tilt and rotation of the head.
The pressure on the cervical nerves may be determined using neurological tests. X-rays can reveal the presence of bony spurs and other abnormalities. Any abnormalities of the cervical spine may be revealed through computerized tomography (abbreviated as CT scan) and magnetic resonance imaging (abbreviated as MRI).
Treatment for Pinched Neck Nerve
The exact treatment of a pinched neck nerve depends on the severity and duration of the signs and symptoms. The following are some treatment measures that may be used in case of cervical nerve compression:
- Cervical collar: A cervical collar (also called a neck brace) can be used to limit the movements of the neck and reduce compression on the nerves.
- Physical therapy: Physiotherapy is used to make the neck muscles stronger.
- Medications: A variety of drugs such as non-steroidal anti-inflammatory drugs (commonly abbreviated as NSAIDs), muscle relaxants and corticosteroid injections may be given to treat compressed neck nerve.
- Surgery: Surgery is only considered as a last resort, when all other treatment options fail to alleviate the signs and symptoms. However, there is no guarantee that a surgical treatment will be able to cure the condition.