Neck pain and back pain get grouped together, but the neck acts differently. It carries the weight of the head on a far smaller frame. It moves through a much wider range. And the nerve roots leaving it supply the arms and hands. That is why neck problems so often show up somewhere else entirely.
A patient with numb fingers, a weak grip, or a headache that starts at the base of the skull often has a neck problem and does not know it.
Cervical radiculopathy is what happens when a nerve root leaving the neck is pinched or irritated. The pinch is in the neck. The symptoms are in the arm.
The pattern is clear enough to make the diagnosis. Pain travels from the neck into the shoulder and down the arm in a band, not spread out. It often reaches certain fingers, depending on which root is involved. It often comes with numbness, pins and needles, or weakness in one movement. You may have trouble gripping, or an arm that tires fast holding something up. Many patients notice the pain eases when they rest a hand on top of their head. That takes the strain off the affected root.
How it is confirmed. The exam finds which root is involved by mapping feeling, reflexes and the strength of certain muscles. Electrodiagnostic testing — EMG and nerve conduction studies — measures how the nerve is really carrying signals. It tells a root problem apart from a nerve trapped further out, like carpal tunnel, and shows how severe it is. Then imaging is read against those findings, not on its own. See hand numbness: carpal tunnel or neck?
How it is treated. Most cervical radiculopathy gets better without surgery. Treatment targets the irritated root directly. That means a cervical epidural steroid injection or a selective nerve root block under live X-ray, along with changes in activity and targeted therapy. The block does two jobs. It confirms which root is to blame and treats it.
Seek emergency care immediately if neck pain comes with any of the following:
Pressure on the spinal cord — cervical myelopathy — shows up differently from radiculopathy. It affects both hands, not one. It affects balance more than pain. And it gets steadily worse instead of coming and going. It is uncommon, and it is urgent.
The order is the same as elsewhere in this practice. The exam comes first. Imaging is read against symptoms, not on its own. And diagnostic blocks are used when the picture is still unclear.
Neck imaging findings are very common in people with no neck pain at all. That is why a scan alone cannot find the source. A fluoroscopically guided medial branch block either stops facet pain for a while or it does not. That answer decides whether radiofrequency ablation is likely to give lasting relief.
Whiplash pain that lasts well past the expected healing time usually has a source we can find. Most often it is the neck’s facet joints. Imaging after a crash is often read as normal. Patients are told that means nothing is wrong. What it really means is that the injury is not the kind that shows on that test.
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. Most cases get better with targeted non-surgical care. That is a statement about how the condition usually runs, not a stance against surgery.
Surgery becomes the right answer when nerve loss keeps getting worse, there are signs of spinal cord pressure, or a pinched nerve has failed every less invasive option. This practice performs surgery. Dr. Gurpreet Singh Padda, MD, MBA, MHP is a licensed physician and surgeon with surgical privileges. The practice starts with the least invasive option that can answer the question.
Some neck pain comes from worn facet joints or strained ligaments and keeps coming back after blocks. For it, an image-guided intra-articular injection of PRP injections treats the joint itself. Read the overview of orthobiologic treatment and how it fits with the strength and metabolic work in your plan.
More on this condition from Dr. Padda on YouTube:
The nerve roots leaving the neck supply the arm and hand. So a root pinched in the neck causes symptoms wherever that nerve travels. Telling it apart from carpal tunnel is exactly what electrodiagnostic testing (nerve testing) is for. See hand numbness: carpal tunnel or neck?
An interventional pain doctor can find which structure is causing it and treat that structure directly. That is the step most often skipped. Our page on choosing a pain specialist covers what to ask before booking.
It may be. Some headaches start at the base of the skull and travel upward, often on one side. These often come from the upper neck or the occipital nerves, not from a headache disorder of their own. See headache that starts in the neck.
Not always. Neck wear findings are very common in people with no symptoms. So imaging has to be read against your exam, not 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 seen here, and you do not need to be a current patient. Same-day appointments are available for sudden pain.
Yes. We have offices on Woodson Road in St. Louis and on Natural Bridge Road. We are licensed in Missouri and Illinois. We see patients from across the Metro East, including Collinsville and Glen Carbon.
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