What it is
A nerve root leaves the spinal cord at each level of the neck and travels into the shoulder, arm and hand. When one is compressed — by a herniated disc, by bone spurs, or by a narrowed exit canal — the result is pain, numbness, tingling or weakness in the territory that nerve supplies.
The pattern is usually recognizable. C6 sends pain into the thumb and index finger; C7 into the middle finger; C8 into the ring and little fingers. That map is a large part of how the level is identified before any imaging is ordered.
Symptoms
- Sharp or burning pain traveling from the neck into the shoulder blade, arm or hand
- Numbness or pins and needles in specific fingers
- Weakness in a particular movement — gripping, straightening the elbow, lifting the arm
- Pain often eased by putting the hand on top of the head, which takes tension off the nerve
How it is diagnosed
Examination identifies which nerve is involved by testing power, reflexes and sensation in a pattern. An MRI confirms the level and the cause. Where imaging shows changes at several levels, a nerve conduction study or a diagnostic injection can establish which one is actually responsible — which matters, because operating on the wrong level is a failure that looks like bad luck.
Non-surgical treatment
The majority improve within six to twelve weeks. Physical therapy, anti-inflammatory medication, activity modification and a short course of oral steroids all help. A cervical epidural or nerve root injection can give substantial relief and is often what carries someone through to recovery without an operation.
When surgery is considered
Persistent arm pain that has not responded to several months of good non-operative care, or progressive weakness at any point. Decompressing the nerve is one of the more reliable operations in spine surgery for arm pain. Whether that is done with a disc replacement, a fusion from the front, or a decompression from the back depends on where the compression sits, your alignment and how many levels are involved.