Cervical Pain

Cervical pain is pain that starts in the neck (the cervical spine) and spreads to the shoulder blade, shoulder or arm. It usually happens when a nerve root leaving the neck is pinched or irritated, a condition called cervical radiculopathy. Most people improve over a few weeks to months without an operation.

Symptoms

• Pain running from the neck to the shoulder blade, shoulder, arm or forearm, usually on one side
• Burning, shooting or electric-like pain, often worse than the neck pain itself
• Tingling or numbness in particular fingers, depending on which nerve is affected
• Weakness of grip or difficulty lifting the arm
• Pain that increases on looking up or turning the head towards the painful side

Causes

• A slip disc in the neck pressing on a nerve root, more common in younger adults
• Bony spurs from cervical spondylosis narrowing the opening through which the nerve passes, more common after 40
• Neck injury, including sports injuries and road accidents
• Repeated strain from heavy overhead work or carrying loads on the head

Pain around the shoulder can also come from the shoulder joint itself, such as a frozen shoulder, so the two must be told apart before treatment.

Diagnosis

The doctor will check the strength of individual arm muscles, the reflexes and the pattern of numbness. Certain neck movements that reproduce the arm pain help confirm nerve involvement, and the shoulder is examined to rule out a joint problem. An MRI of the cervical spine shows the exact level and cause of compression. Nerve conduction studies are sometimes advised to look for nerve compression at the wrist or elbow.

Treatment

Initial treatment is non-surgical. Avoiding activities that provoke the arm pain, such as working with the arms raised or looking up for long, gives the nerve time to settle. Your doctor may prescribe pain-relieving medicines along with medicines that specifically calm nerve pain. Once the severe pain eases, physiotherapy with gentle neck exercises, posture correction and, in some patients, supervised traction can help. A targeted nerve root injection may be considered when pain remains severe.

Surgery is advised when arm pain continues despite several weeks of proper treatment, when weakness is increasing, or when the MRI shows pressure on the spinal cord. Options include removing the disc from the front of the neck and stabilising the level (anterior cervical discectomy and fusion), disc replacement in selected patients, or widening the nerve opening from the back (foraminotomy), which can be done by minimally invasive or endoscopic techniques in suitable cases.

When to Seek Urgent Care

• Left arm or shoulder pain with chest pain, breathlessness or sweating, which may be a heart attack
• Rapidly increasing weakness of the arm or hand
• Weakness or numbness in both arms or in the legs, or unsteady walking
• Loss of control over passing urine or stools
• Arm and neck pain after a fall or road accident, or with fever

Go to the nearest emergency department immediately if any of these occur.

If pain from your neck is spreading into your shoulder or arm, consult Dr. Prashant Sharma at Keshav Super Speciality Hospital, Meerut, to find the cause and plan the right treatment.

Related Conditions

• Cervical Spondylosis
• Lumbar Spondylosis
• Slip Disc
• Spinal Nerve Pain (Radiculopathy)
• All Spinal Treatment ›