What is nerve root pain of the neck?
Patients who have had an operation for a slipped disc may still feel pain radiating to their arm, even if the vertebral disc is no longer pressing against the nerve. This is called nerve root pain or radiculopathy.
The slipped disc has damaged a nerve root, so that it no longer functions properly. The nerve root spontaneously produces signals (electrical impulses) that are sent to the spinal cord. From there, they are passed on to the brain, producing a sensation of pain radiating to the arm.
Signs and symptoms
The main complaint by patients with cervical nerve root pain is pain radiating to their arm. The pain is often sharp and stabbing. The patient may also complain of numbness, tingling and/or muscle weakness.
How is nerve root pain of the neck diagnosed?
If you visit the clinic with pain radiating to your arm, it is very likely that you have nerve root pain. The neurological examination includes a number of tests that can confirm this diagnosis.
In addition, the doctor will test the mobility of your neck, to see whether certain movements are restricted or painful. The doctor will also feel your neck to see whether pressing on any of the vertebrae causes pain.
Do I need additional examinations?
- Diagnostic examination for other non-physical factors important for your pain, have already been done by yourself trough filling out your pain questionnaires.
- Since the neurological examination usually confirms the diagnosis, further examinations are not always necessary, as they will not influence the treatment. What is important to know is that many people who do not have any complaints are still found to have a protruding cervical disc when they are examined with an MRI scan. On the other hand, an MRI scan of the neck may reveal no herniated disc even if the doctor suspected one because of pain radiating to the arm, for instance because the patient has a radiculopathy.
- An MRI scan only needs to be made if there is doubt about the diagnosis. An MRI scan may reveal other possible causes of the pain. A CT scan is usually not useful, as it only shows clear images of the bones.
- Sometimes an examination of the patient's muscles (EMG) is done, to check which nerve root in the neck is causing the pain.
- Nerve root test blocks can also be used to check which nerve root in the neck is causing the pain in the arm.
What are my treatment possibilities?
Depending on the cause of your pain, your pain specialist will decide whether or not to embark on physical treatment. Based on the results of the completed pain questionnaire, additional examinations can be carried out and, apart from physical treatment, other methods of treatment will be suggested.
If the results of your pain questionnaire are abnormal, your pain specialist will offer you one of the non-physical treatments listed below:
- Psychological Treatment
- Depression Treatment
- Cognitive-Behavioural Treatment
- Rehabilitation Treatment
Interventional Pain Treatments
- Epidural injections
- PRF treatment of a nerve root
- Spinal cord test stimulation
- Spinal cord stimulation