UMEM Educational Pearls

Axial neck pain is a dull aching “soreness” pain from the posterior neck muscles with radiation to the occiput, periscapular and shoulder regions.

Associated with headaches, stiffness and muscle spasm. 

Patients with cervical radiculopathy, however, usually present with unilateral pain discomfort.

Patients may complain of pain radiation into the ipsilateral arm. Though frequently difficult to describe, this may be in a dermatomal distribution. Patients may also report decreased sensation in a dermatomal distribution or weakness along the corresponding myotome.

The most affected nerve roots are C7 (C6-7 herniation), followed by C6 (C5-6 herniation) and C8 (C7-T1 herniation).

Cervical Spondylosis (degenerative change) is the most common ideology.

As discs breakdown with age and lose height, increased force loads are transmitted to bony regions of the spinal segment leading to bone hypertrophy which creates foraminal stenosis and resultant radiculopathy.

Cervical radiculopathy, like lumbar radiculopathy, is largely a self-limited condition. Several older studies following this diagnosis revealed that a majority of patients were either asymptomatic or mildly symptomatic at time of follow-up. 

Improvement is seen over the initial four to six months following diagnosis.