Cervical Radiculopathy

Cervical radiculopathy is irritation or compression of a nerve root as it exits the cervical spine. The most common levels are C6 and C7, and the most common causes are a soft disc herniation in younger patients or bone-spur narrowing of the foramen in older patients.

The nerve travels down your arm to specific muscles and skin regions, so the symptoms follow recognizable patterns — pain into the shoulder blade and down the arm, numbness in particular fingers, weakness in specific muscles.

I take a focused history and exam — strength of specific muscle groups, reflexes, sensation, and provocative maneuvers like the Spurling test. An MRI confirms the level and tells us whether the cause is a soft disc or bone-spur narrowing.

The vast majority of cervical radiculopathy improves with conservative care: anti-inflammatories, physical therapy with traction and gentle mobilization, activity modification, and sometimes an epidural steroid injection. About 80% of patients are substantially better by three months without surgery.

The decision to operate isn't about the imaging alone — it's about whether your symptoms are severe, persistent, or progressing despite an honest attempt at conservative care.

Surgery is considered when arm pain is severe and unresponsive to several weeks of appropriate conservative care, or when there is progressive motor weakness in the affected nerve distribution.

For the right patient, the choice is usually ACDF (anterior cervical discectomy and fusion) or cervical disc arthroplasty (motion-preserving replacement). Both have decades of outcome data; the right choice depends on your specific imaging and your priorities. We talk through both, and we decide together.