Arm pain from a cervical herniated disc is one of the more common cervical spine conditions. It usually develops in the 30-50 year old age group. Although a cervical herniated disc may originate from some sort of trauma or injury to the cervical spine, the symptoms commonly start spontaneously.
When you feel pain, it’s a reaction to signals transmitted throughout your body. These signals are sent from the pain source through the nerves in the spinal cord and into the brain, where they are perceived as pain. Problems that originate in the cervical spine may result in pain and other symptoms, such as tingling, numbness and muscle weakness, which may be localized in the neck and/or extend into the shoulders, arms and hands.
Degenerative conditions in the vertebrae of your neck or cervical spine are a common source of arm pain.
Arm pain from a cervical herniated disc results because the herniated disc material “pinches” or presses on a cervical nerve, causing pain to radiate along the nerve pathway down the arm. Numbness and tingling can be present down the arm and into the fingertips.
Pain radiating into either or both arms is called cervical radiculopathy. Numerous conditions can cause cervical radiculopathy, but the most common is a herniated disc (herniated nucleus pulposus). When an intervertebral disc is injured and protrudes into the spinal canal, it can impinge on the spinal cord and nerves, resulting in pain in the neck, and one or both arms.
Other conditions may also cause radiculopathy, such as a bone spur (osteophyte) pinched nerve, or more rarely a tumor or infection. 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.
Arm and hand symptoms may manifest as shooting electricity pain down the shoulder, arm, forearm, hand, and into specific fingers. The radicular pain may also have a component of numbness, tingling (paresthesia), and/or weakness. Shoulder pain that arises from within the shoulder joint, particularly with raising the arm and shoulder generally indicates a shoulder problem such as bursitis or a rotator cuff injury. This type of pain is called referred pain, when the pain of a nearby joint causes the entire region or extremity to be painful.
The diagnosis of radiculopathy is typically made by taking a detailed patient history. Physical examination can further clarify the diagnosis. However, an MRI of the cervical spine will often be required to confirm the actual cause of the radicular pain. It is important for the clinician to conduct a thorough history and clinical examination prior to formulating the final diagnosis so as not to misdiagnose this condition.
Electromyography and nerve conduction velocity (EMG/NCV) tests are useful to determine which nerve is affected, and how severely it is damaged or irritated. The test will often clarify specifically where a nerve is being compressed – whether it is a spinal nerve in the neck or a peripheral nerve in the shoulder, elbow, forearm, or wrist.
For patients whose symptoms are not alleviated through other treatments such as physical therapy or injections, surgery to remove or repair the damaged portion of nerve may be necessary.
Outcome and prognosis after treatment can vary depending on the location and type of injury that occurred. In some cases, recovery after treatment will be slow, and return to full function may be challenging. However, for most patients, total return to normal function is likely, and recovery after treatment or surgery is approximately 2 to 8 weeks.
If you are suffering from chronic arm pain or pain as a result of a physical trauma involving your neck, such as a fall or car accident, you should seek treatment from a physician at the Florida Spine Institute to better understand your condition and determine the most appropriate treatment option for you.
References
Annular Tear (2012). Wheeless’ Textbook of Orthopaedics. Available at: http://www.wheelessonline.com/ortho/annular_tear. Last accessed December 8, 2014.
Windsor RE, et al. Cervical Disc Injuries (2012). Medscape. Available at: http://emedicine.medscape.com/article/93635-overview. Last accessed December 8, 2014.
