Neck pain and back pain get grouped together, but the neck behaves differently. It carries the weight of the head on a far smaller structure, it has a much greater range of motion, and the nerve roots leaving it supply the arms and hands — which is why neck problems so often announce themselves somewhere else entirely.
A patient with numb fingers, a weak grip, or a headache that starts at the base of the skull frequently has a neck problem and does not know it.
Cervical radiculopathy is what happens when a nerve root leaving the cervical spine is compressed or irritated. The compression is in the neck; the symptoms are in the arm.
The pattern is specific enough to be diagnostic. Pain travels from the neck into the shoulder and down the arm in a band rather than diffusely, often reaching particular fingers depending on which root is involved. It is commonly accompanied by numbness, pins and needles, or weakness in a specific movement — difficulty gripping, or an arm that tires quickly holding something up. Many patients notice the pain eases when they rest a hand on top of their head, which unloads the affected root.
How it is confirmed. Examination establishes which root is involved by mapping sensation, reflexes and specific muscle strength. Electrodiagnostic testing — EMG and nerve conduction studies measures how the nerve is actually conducting, distinguishes a root problem from a peripheral entrapment like carpal tunnel, and gauges severity. Imaging is then read against those findings rather than on its own. See hand numbness: carpal tunnel or neck?
How it is treated. Most cervical radiculopathy improves without surgery. Treatment targets the irritated root directly — cervical epidural steroid injection or a selective nerve root block under fluoroscopic guidance, alongside activity modification and targeted therapy. The block does double duty: it confirms which root is responsible and treats it.
Seek emergency care immediately if neck pain comes with any of the following:
Cord compression — cervical myelopathy — presents differently from radiculopathy: both hands rather than one, balance rather than pain, and progressive rather than fluctuating. It is uncommon and it is urgent.
The sequence is the same as elsewhere in this practice: examination first, imaging read against symptoms rather than in isolation, and diagnostic blocks where the picture remains ambiguous.
Cervical imaging findings are extremely common in people with no neck pain at all, which is why a scan alone cannot establish the source. A fluoroscopically guided medial branch block either abolishes facet-mediated pain temporarily or it does not — and that answer determines whether radiofrequency ablation is likely to give durable relief.
Whiplash pain that persists well beyond the expected healing period usually has an identifiable structural source, most often the cervical facet joints. Imaging after a collision is frequently read as normal, which patients are told means nothing is wrong — when what it actually means is that the injury is not the kind that shows on that study.
See neck pain months after a car accident and care after a motor vehicle accident.
For most neck pain, including most cervical radiculopathy, surgery is not the treatment — the majority improves with targeted non-surgical care. That is a statement about the natural history of the condition, not a position against surgery.
Surgery becomes the right answer where there is progressive neurological deficit, signs of cord compression, or a compressive lesion that has exhausted less invasive options. This practice performs surgery; Dr. Gurpreet Singh Padda, MD, MBA, MHP is a licensed physician and surgeon with surgical privileges. It leads with the least invasive option that can answer the question.
The nerve roots leaving the cervical spine supply the arm and hand, so a root compressed in the neck produces symptoms wherever that nerve travels. Distinguishing it from carpal tunnel is exactly what electrodiagnostic testing is for — see hand numbness: carpal tunnel or neck?
An interventional pain physician can establish which structure is generating it and treat that structure directly, which is the step most often skipped. Our page on choosing a pain specialist covers what to ask before booking.
It may be. Headache that begins at the base of the skull and travels upward, often on one side, frequently originates from the upper cervical segments or the occipital nerves rather than being a primary headache disorder. See headache that starts in the neck.
Not necessarily. Cervical degenerative findings are very common in people with no symptoms, so imaging has to be interpreted against your examination rather than treated as a verdict. That is why diagnostic blocks exist. See why medications and surgery may not fix pain.
No. You do not need a referral to be evaluated here, and you do not need to be an existing patient. Same-day appointments are available for acute pain.
Yes. Offices on Woodson Road in St. Louis and Natural Bridge Road in Bridgeton, licensed in Missouri and Illinois, seeing patients from across the Metro East including Collinsville and Glen Carbon.
Call (314) 481-5000 or request an appointment. See all conditions we treat.
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