Symptoms of cervical radiculopathy

No matter how successful a person's career is, or how many connections and friends he has around him, no matter how poor or destitute he is, he should clearly realize that all these things happen on one basis, that is, life. Only the existence of life gives you the opportunity to live in this world in your own way. But if you even have life, you have lost the meaning of existence.

Maybe some people live a quiet life every day and rush around for a living. Maybe one day you will find that your hands become numb from time to time. Because it only happens occasionally, you may not take it too seriously, but you don’t know that the disease has quietly come to you.

1. Neck symptoms may vary in severity depending on the cause of the radicular compression. Those mainly caused by nucleus pulposus herniation are often accompanied by obvious neck pain, paraspinal muscle tenderness and upright neck position due to direct stimulation of the local sinus nerve. Direct tenderness or percussion pain on the cervical spinous process or between the spinous processes are mostly positive, and these manifestations are particularly obvious in the acute stage. If it is caused by simple atlantoaxial joint degeneration and bone hyperplasia, the neck symptoms will be mild and there may even be no special findings.

2. Radicular pain is the most common, and its range is consistent with the distribution area of ​​the spinal nerve roots of the affected vertebrae (Figure 1). At this time, it must be distinguished from dry pain (mainly radial nerve trunk, ulnar nerve trunk and median nerve trunk) and plexus pain (mainly cervical plexus, brachial plexus and axillary plexus). Accompanying radicular pain are other sensory disturbances in the distribution area of ​​the nerve root, among which numbness of the fingers, hyperesthesia of the fingertips and decreased skin sensation are the most common.

3. Radicular muscle dysfunction is more obvious when the front roots are compressed first. In the early stage, muscle tension increases, but it quickly weakens and muscle atrophy occurs. The affected area is also limited to the muscle group innervated by this spinal nerve root. In the hands, the thenar and hypothenar muscles and interosseous muscles are the most obvious. It also needs to be distinguished from trunk and plexus muscular atrophy, and from muscle strength changes caused by spinal cord lesions. If necessary, electromyography or cortical evoked potential tests can be performed for identification.

4. Changes in tendon reflexes refer to abnormalities in the reflex arcs involving the affected spinal nerve roots (Figure 2). It is active in the early stage, but decreases or disappears in the middle and late stages. It should be compared with the contralateral side during examination. Simple root involvement should not cause pathological reflexes. If accompanied by pathological reflexes, it means that the spinal cord is also affected.

5. Special tests: Most traction tests that increase the tension of the spinal nerve roots are positive (Figure 3), especially in the acute phase and later when the roots are mainly compressed. Positive cervical compression tests are mostly seen in cases with nucleus pulposus protrusion, nucleus pulposus herniation and vertebral instability; those caused by uncovertebral hyperplasia are mostly weakly positive; and those caused by space-occupying lesions in the spinal canal are mostly negative.

The disease characteristics introduced above are about the symptoms of radiculopathy of cervical spondylosis. Although the name of this disease is long, the long name does not necessarily mean that it is an incurable disease. The treatment of this disease can be divided into two forms, one is surgical treatment and the other is non-surgical treatment. However, in non-surgical treatment, doctors recommend that massage is not appropriate.