Medicurio

Cervical radicular syndrome is the general name for both cervical radicular pain and cervical radiculopathy. Despite the fact that the terms “radicular pain” and “radiculopathy” are interchangeable in the literature, they are different conditions. Radicular pain is “pain arising from ectopic discharges from a dorsal root or its ganglion.” The most frequent cause, disc herniation (hernia nucleus pulposus, HNP), and inflammation of the nerve involved are believed to play a key pathophysiological role in this condition. Another distinct condition, radiculopathy, is different from the previous one.It is characterized by the disruption of conduction within spinal nerve or roots (Bogduk et al. 2009). There appear objective evidence of neurologic dysfunction such as sensory (hypoesthesia or anesthesia), motor (paresis or atrophy), or reflex (hyporeflexia) disorders.(Kapitza et al., 2020)

While the mechanical compression of these structures is a primary driver, secondary ischemia and metabolic disruption often exacerbate the axonal conduction block (Mansfield et al., 2020).

Consequently, while radicular pain manifests primarily as shooting discomfort within a specific dermatomal distribution, the presence of these objective neurological deficits serves as the clinical hallmark for confirming a diagnosis of radiculopathy (ASIPP, 2013; Caridi et al., 2011). Differential diagnosis remains essential in this clinical process, as the presence of radicular symptoms can often be mimicked by various shoulder pathologies or localized entrapment neuropathies (Abbed & Coumans, 2007; Shim & Shin, 2025). Accurate identification of the affected spinal segment frequently relies on meticulous clinical history taking, supplemented by provocative maneuvers such as Spurling’s test (Kang et al., 2020; Lin et al., 2026). Furthermore, clinicians must be aware that these symptoms can often present with atypical patterns that do not strictly adhere to classic dermatomal or myotomal distributions, which complicates the diagnostic process (Lee, 2025). Given these clinical complexities, electrodiagnostic testing may serve as a valuable diagnostic tool to exclude peripheral neuropathies and confirm the localization of nerve root involvement (Childress & Becker, 2016). Despite the utility of such testing, clinicians should note that diagnostic imaging findings often correlate only partially with physical examination results (Benditz et al., 2017).

Symptoms

Common symptoms of neck pain include:

• Pain that gets worse when you hold your head in the same position for a long time, such as when driving or working at a computer.
• Muscle tightness and muscle spasms.
• Trouble moving your head.
• Headaches.

Causes

The neck supports the head and is less protected than other parts of the spine, making it vulnerable to injury. Even minor injuries can cause stiffness and pain and limit movement.

Common causes of neck pain include:

• Muscle strain. Sitting hunched over a computer, looking down at a smartphone, or reading in bed can strain the neck muscles and cause pain. A recent study found that people who sit for more than six hours a day are more likely to have neck pain. The risk is even higher when they spend that time using a computer or smartphone.(Ayhualem et al., 2021)
• Worn joints. Like other joints in the body, the joints in the neck tend to wear down with age. Arthritis in the neck can cause pain and make it difficult to move the neck.(Shamsi et al., 2024)
• Pinched nerves, also called nerve compression. Bulging disks or bone spurs in the neck can press on nearby nerves, causing pain that may spread to the arms(Che et al., 2025).
• Injuries. Car accidents, especially those that cause the head to jerk forward and backward, can damage the soft tissues in the neck. This type of injury is called whiplash.(Delgado-Garcia et al., 2024)
• Diseases. Certain diseases, such as rheumatoid arthritis, meningitis, or cancer, can cause neck pain.(Douglass & Bope, 2004)

Risk factors

There are certain factors that increase your risk of having neck pain:

• Your age. It is more likely to occur when you are over 40 years old.
• Poor posture. Your head is supposed to sit on top of your neck like a golf ball sits on a tee. When you slouch, hunch or bend your neck forward or downward for a long period of time, for example, when you use a phone or a computer, you apply too much weight and cause stress on the muscles, joints, and discs of the neck.
• Repetition of movements. If your work or activities involve moving your neck in repetitive movements, you are at risk of developing neck pain.
• Injury. Falls, athletic injuries, or car crashes may damage your neck.
• Stress. Stress makes your neck muscles tense.
• Some other medical conditions. Diseases like arthritis, infection, or cancer also may be responsible for the problem.

Prevention

Most neck pain is caused by a mix of poor posture and aging. To help prevent neck pain, keep your head centered over your spine. Making a few small changes in your daily habits can help protect your neck. Here are some tips to try:

• Practice good posture. When standing or sitting, keep your shoulders in a straight line over your hips. Keep your ears directly over your shoulders. When using a smartphone, tablet or other small screen, hold the device up at eye level rather than bending your neck to look down.
• Take regular breaks. If you work at a computer or travel long distances, get up often to move around and stretch your neck and shoulders.
• Set up your workspace. Adjust your desk, chair and computer so your monitor is at eye level. When sitting, your knees should be slightly lower than your hips. Use the chair’s armrests to support your arms.
• If you smoke, quit. Smoking increases the risk of developing neck pain.
• Be careful with heavy bags. Carrying heavy bags over one shoulder can strain your neck. Keep bags light or use a backpack that spreads weight evenly.
• Sleep in a healthy position. Keep your head and neck aligned with your body when you sleep. Use a small pillow to support your neck. Try sleeping on your back with pillows under your knees or thighs, which can help relax your spine.
• Stay active. Moving your body regularly helps keep your neck and back strong. If you sit a lot, try to add more movement to your day.

Diagnosis

To diagnose neck pain, your healthcare professional asks about your symptoms and medical history. This is followed by a physical exam to check for tenderness, numbness and muscle weakness. Your healthcare professional checks how far you can move your head forward, backward and side to side.

Imaging tests

Imaging tests may be ordered to help find the cause of your neck pain. These may include:

• X-rays. X-rays can show areas in the neck where the nerves or spinal cord may be pinched by bone spurs or other changes.
• CT scan. A CT scan takes many X-ray images from different angles to create a detailed picture of the inside of your neck.
• MRI. An MRI uses radio waves and a strong magnet to make detailed images of bones and soft tissues. The soft tissues include the disks, spinal cord and nerves.

It’s possible to have X-ray or MRI images show structural issues in the neck without neck pain. Imaging studies are best used with a careful history and a physical exam to diagnose the cause of neck pain.

Other tests

• Electromyography, also called EMG. This test is done to see if a pinched nerve may be causing your pain. A healthcare professional places small needles into muscles to measure how well your nerves are working.
• Blood tests. Sometimes blood tests can show signs of infection or inflammation that may be causing neck pain or making it worse.

Raynaud’s phenomenon is a vasospastic disorder that affects the hands triggered by cold or emotional stress resulting in symptoms of pain, pallor progressing to cyanosis, and coolness of the distal extremities. These changes are thought to be due to intimal layer hypertrophy and inflammation; collagen disposition and fibrosis resulting in vessel lumen occlusion. These vascular alterations have been described in the digital arteries, superficial palmar arch and ulnar artery. Angiographic studies have demonstrated little or no collateral circulation distal to the fibrotic vessels. Radiographic findings in the hands may include soft tissue calcifications when the patient has Raynaud’s as part of CREST syndrome, atrophy of the finger tips, acroosteolysis and intercarpal joint space narrowing. The differential diagnosis for acroosteolysis includes: psoriasis, injury (frostbite or thermal burns), neuropathy (diabetes, leprosy, myelomeningocele), collagen vascular disease, hyperparathyroidism, polyvinyl chloride (PVC) exposure, snake/scorpion venom and familial forms (Hadju-Cheney syndrome).