Are you dealing with persistent neck pain? What about a strange tingling or numbness that travels down your arm and into your fingers? Or maybe you’ve noticed a new clumsiness in your hands or an unsteadiness when you walk. These feelings aren’t just a normal part of getting older—they can be signs of specific conditions in your cervical spine, which is the part of your spine that makes up your neck.
Two common conditions that cause these symptoms are cervical radiculopathy and cervical myelopathy. While their names sound complex, they can be understood as “pinched nerve” and “spinal cord compression.”
At California Pacific Orthopaedics, our team of renowned spine specialists in San Francisco is dedicated to diagnosing and treating these conditions. We use state-of-the-art technology and a patient-first approach to help you understand your symptoms and find the most effective path back to a pain-free life.
Common Symptoms and Causes
It’s important to understand the difference between these two conditions, as their symptoms and level of urgency can vary. You can have one, the other, or both at the same time.
Symptoms of Cervical Radiculopathy (Pinched Nerve)
Cervical radiculopathy happens when a nerve root in your neck becomes irritated or compressed as it branches off from the spinal cord. Think of it like a kink in a garden hose—the pressure at one point causes problems all the way down the line. Because these nerves supply sensation and strength to your arms, the symptoms are often felt there.
Common symptoms of a pinched nerve in the neck include:
- Radiating Pain: A sharp, burning, or aching pain that starts in the neck and travels down the shoulder, arm, hand, or into the fingers. It usually affects just one side.
- Numbness or Tingling: A “pins-and-needles” sensation in your arm or fingers.
- Muscle Weakness: You might notice difficulty lifting objects, or weakness in your shoulder, elbow, or hand muscles.
- Loss of Reflexes: Your doctor may notice diminished reflexes in your arm during an examination.
Symptoms of Cervical Myelopathy (Spinal Cord Compression)
Cervical myelopathy is a more serious condition where the spinal cord itself is being squeezed. The spinal cord is the main highway for nerve signals between your brain and the rest of your body. When it’s compressed in the neck, it can disrupt signals to your arms, legs, and other body parts. This condition often develops slowly but can lead to significant disability if left untreated.
Common symptoms of spinal cord compression include:
- Clumsiness and Poor Hand Coordination: Difficulty with fine motor skills like buttoning a shirt, writing, or handling keys and coins.
- Widespread Numbness or Weakness: A vague feeling of weakness or numbness in the arms and sometimes the legs.
- Balance Issues: Difficulty walking, a feeling of unsteadiness on your feet, or needing to hold onto something for support. This is known as gait imbalance.
- Changes in Leg Function: Your legs may feel heavy or stiff, making it hard to walk quickly.
- Urgency in a rush: In advanced stages, myelopathy can affect bladder or bowel control. If you experience this, seek medical attention immediately.
What Causes These Conditions?
Most often, cervical myelopathy and radiculopathy are caused by age-related, degenerative changes in the spine. This is often referred to as spondylosis, or arthritis of the neck.
Key causes include:
- Herniated Discs: The soft, gel-like discs that cushion the bones (vertebrae) of your spine can bulge or break open, pressing on the nerve roots or spinal cord.
- Bone Spurs: Also called osteophytes, these are small, bony growths that can form on your vertebrae. They are the body’s response to inflammation from arthritis but can narrow the space available for your nerves and spinal cord.
- Spinal Stenosis: This is a general term for the narrowing of the spinal canal. Degenerative changes like bulging discs and bone spurs contribute to this narrowing over time.
- Degenerative Disc Disease: As we age, our spinal discs can dry out, shrink, and lose their cushioning ability, leading to instability and pressure on the surrounding nerves.
Common Risk Factors
While anyone can develop these conditions, certain factors can increase your risk.
- Age: Age is the number one risk factor. These conditions are most common in people over 50 due to natural wear and tear on the spine.
- Occupation: Jobs that involve repetitive neck movements, heavy lifting, or prolonged “head-down” postures can put extra stress on your cervical spine.
- Previous Injury: A past trauma to the neck, like whiplash from a car accident, can accelerate degenerative changes.
- Smoking: Nicotine has been shown to damage spinal discs and speed up the degenerative process.
- Genetics: You may have a genetic predisposition to developing disc problems or arthritis.
Diagnosis and Treatment in the Bay Area
Getting an accurate diagnosis is the first and most important step. At California Pacific Orthopaedics, our spine specialists will start with a comprehensive evaluation.
Your Consultation
During your visit, your doctor will:
- Discuss Your Symptoms: They’ll ask detailed questions about your pain, numbness, weakness, and how it affects your daily life.
- Perform a Physical Exam: This includes testing your muscle strength, sensation, reflexes, and balance. They will also likely watch you walk to check your gait.
Advanced Imaging
To confirm a diagnosis and pinpoint the exact source of the problem, your doctor may order imaging tests:
- MRI (Magnetic Resonance Imaging): This is the best test for viewing soft tissues. It clearly shows the spinal cord, nerve roots, and discs, and can reveal any compression.
- X-rays: These images show the alignment of your bones and can identify problems like fractures, bone spurs, or arthritis.
- CT (Computed Tomography) Scan: A CT scan provides a more detailed look at the bony structures of your spine than an X-ray.
Your Personalized Treatment Plan
Our philosophy is to start with the most conservative treatment options first.
Non-Surgical Treatments
For many patients with cervical radiculopathy, symptoms can be managed without surgery. Options include:
- Physical Therapy: To strengthen neck muscles, improve posture, and reduce pressure on the nerves.
- Medication: Anti-inflammatory drugs (like ibuprofen) can reduce swelling and pain.
- Corticosteroid Injections: An injection of powerful anti-inflammatory medicine near the affected nerve can provide significant, though often temporary, relief.
Surgical Treatments
Surgery is typically recommended for cervical myelopathy, as it tends to worsen over time. It may also be an option for cervical radiculopathy if conservative treatments have failed or if you have significant muscle weakness.
The goal of surgery is decompression—to create more space for your spinal cord and nerves. Our surgeons in San Francisco are experts in advanced procedures such as:
- Anterior Cervical Discectomy and Fusion (ACDF): The surgeon removes the problematic disc and/or bone spurs from the front of the neck and then stabilizes the vertebrae with a bone graft and plate.
- Cervical Disc Replacement: The damaged disc is removed and replaced with an artificial disc designed to preserve motion in the neck.
- Laminoplasty: The surgeon creates more space for the spinal cord by altering a portion of the vertebra from the back of the neck, without performing a fusion.
If you are experiencing symptoms of a pinched nerve or spinal cord compression, it’s essential to seek expert care. The dedicated team at California Pacific Orthopaedics is here to provide the answers and treatment you need. Contact our San Francisco office today to schedule your consultation and take the first step toward relief.
