Skip to main content
SpringerLink
Log in
Book cover

Fundamentals of Pain Medicine pp 187–194Cite as

Cervical Radicular Pain

  • Chapter
  • First Online:

  • 2360 Accesses

Abstract

Cervical radicular pain is pain along a dermatomal pattern that is caused by the irritation of a nerve root. It is mediated by phospholipase A2, interleukins 1 and 6, TNF-α, and nitric oxide. Cervical radicular pain is often, but not always, associated with nerve root compression, as evidenced by a patient with radicular pain but without evidence of nerve root compression on imaging. Cervical radicular pain is a separate entity from cervical radiculopathy, which involves a sensory or motor deficit from a dysfunctional nerve pathway.

The diagnosis of cervical radicular pain can be accomplished through a multifaceted approach. A thorough history and physical exam that includes provocative tests such as a Spurling test, a shoulder abduction test, and an axial manual traction test can help differentiate cervical radicular pain from discogenic or facetogenic pain. Diagnostic nerve blocks, EMG, and imaging studies can determine the exact nerve root level that is causing pain. Treatment options include conservative medical treatment, physical therapy, cervical epidural steroid injections, or spinal cord stimulation.

This is a preview of subscription content, log in via an institution.

Abbreviations

CT:

Computed tomography

EMG:

Electromyography

MRI:

Magnetic resonance imaging

TNF:

Tumor necrosis factor

Suggested Reading

  1. Anderburg L, Annertz M, Rydholm BL, Saveland H. Selective diagnostic nerve root block for the evaluation of radicular pain in the multilevel degenerated cervical spine. Eur Spine J. 2005;15:794–801.

    Article  Google Scholar 

  2. Carette S, Fehlings MG. Cervical radiculopathy. N Engl J Med. 2005;353:392–9.

    Article  CAS  PubMed  Google Scholar 

  3. Cohen SP, Bicket MC, Jamison D, Wilkinson I, Rathmell JP. Epidural steroids: a comprehensive, evidence-based review. Reg Anesth Pain Med. 2013;38:175–200.

    Article  CAS  PubMed  Google Scholar 

  4. Daffner RH, Weissman BN, Angevine PD, Arnold E, Bancroft L, Bennett DL, et al. Expert Panel on Musculoskeletal Imaging. ACR Appropriateness Criteria® chronic neck pain. [online publication]. National Guideline Clearinghouse Available at http://www.guideline.gov/content.aspx?id=23823.

  5. Keyes RD. Nerve conduction studies and electromyography. Can Fam Physician. 1990;36:317–20.

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Maus TP. Radiologic assessment of the patient with spine pain. In: Benzon H, Rathmell JP, Wu CL, Turk DC, Argoff CE, Hurley RW, editors. Practical management of pain. Philadelphia: Elsevier Mosby; 2014.

    Google Scholar 

  7. Radhakrishnan K, Litchy WJ, O’Fallon WM, Kurland LT. Epidemiology of cervical radiculopathy: a population-based study from Rochester, Minnesota, 1976 through 1990. Brain. 1994;117:325–35.

    Article  PubMed  Google Scholar 

  8. Van Zundert J, Huntoon M, Patijn J, Lataster A, Mekhail N, Van Kleef M. Cervical radicular pain. Pain Pract. 2009;10(1):1–17.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anesthesiology and Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Robert W. Hurley MD, PhD

  2. Department of Anesthesiology and Pain Medicine, University of Florida Health, 1600 SW Archer Rd, MSB-500, Gainesville, FL, 32608, USA

    Jennifer L. Chang MD

Authors
  1. Robert W. Hurley MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jennifer L. Chang MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jennifer L. Chang MD .

Editor information

Editors and Affiliations

  1. Professor of Anesthesiology President-elect, American Academy of Pain Medicine, Director, Cleveland Clinic Multidisciplinary Pain Medicine Fellowship Program, Departments of Pain Management and Neurosciences, Cleveland Clinic Anesthesiology Institute and Lerner Research Institute, Cleveland, Ohio, USA

    Jianguo Cheng

  2. Chairman, Department Pain Management, Cleveland Clinic, Cleveland, Ohio, USA

    Richard W. Rosenquist

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Hurley, R.W., Chang, J.L. (2018). Cervical Radicular Pain. In: Cheng, J., Rosenquist, R. (eds) Fundamentals of Pain Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-64922-1_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-64922-1_20

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-64920-7

  • Online ISBN: 978-3-319-64922-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation