However, an MRI of the cervical spine will often be required to confirm the actual cause of the radicular pain. Physical examination can further clarify the diagnosis.

The diagnosis of radiculopathy is typically made by taking a detailed patient history alone. The test will often clarify where a nerve is actually being compressed – whether it is a spinal nerve in the neck or a peripheral nerve in the shoulder, elbow, forearm, or wrist. Special TestsĮlectromyography and nerve conduction velocity (EMG/NCV) tests are useful to determine which nerve is affected, and how severely it is damaged or irritated. Occasionally, specific tests are ordered to rule out infection or other causes or neck pain and/or arm pain, numbness, and weakness.

There are no laboratory tests used to diagnose a herniated disc or radiculopathy. However, x-rays do not allow one to visualize the soft tissues of the spine such as disc, nerves, or muscles, and usually will not identify the cause of sciatica symptoms. Regular x-rays are most useful to evaluate fractures, instability, or arthritis changes of the spine. An MRI utilizes a powerful magnet and computer system to generate images in three dimensions of all structures, including the intervertebral disc, spinal cord and nerves, muscles, bone, and other soft tissues. Imaging StudiesĪn MRI of the spine is most useful to evaluate a patient with cervical radiculopathy. Deep tendon reflexes may be diminished or absent for the particular spinal nerve that is affected. Patients with longstanding nerve compression and muscle weakness may demonstrate atrophy (decreased size) of the affected muscle(s), and this may be quite noticeable when comparing it with the opposite arm. There may be significant weakness in one or more muscle groups and numbness in a specific dermatomal distribution. Patients with cervical radiculopathy may have decrease cervical (neck) range-of-motion, especially rotation (looking from side to side). Since the majority of patients with cervical radiculopathy have the underlying diagnosis of a herniated disc, the physical findings are usually the same. This type of pain is called referred pain, when the pain of a nearby joint causes the entire region or extremity to be painful. Shoulder pain that arises from within the shoulder joint, particularly with abduction and raising the arm and shoulder generally indicates a shoulder problem such as bursitis or a rotator cuff injury. Patients may have difficulty turning their head because of the pain. The radicular pain may also have a component of numbness, tingling (parasthesia), and/or weakness. The arm and hand symptoms may manifest as a shooting electricity pain down the shoulder, arm, forearm, hand, and into specific fingers. Radiculopathy is typically present in one arm only, but occasionally occurs in both arms. Conditions affecting the brachial plexus and nerves in the shoulder or the median, ulnar, and radial nerves in the arm and wrist can also cause neurologic dysfunction similar to cervical radiculopathy. Other conditions may also cause radiculopathy, such as a bone spur (osteophyte) pinching a spinal nerve, or more rarely a tumor or infection. If the pain radiates into the arms(s), it is called radiculopathy. The pain may be in the neck or arms(s), or both. When an intervertebral disc is injured and protrudes into the spinal canal, it can impinge on the spinal cord and nerves and cause pain. There are numerous conditions that can cause cervical radiculopathy, but the most common is a herniated disc (herniated nucleus pulposus).

Cervical spine nerves impingement x ray