Cervical Radiculopathy - Everything You Need To Know - Dr. Nabil Ebraheim
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- Опубликовано: 26 сен 2024
- Dr. Ebraheim’s educational animated video describes the condition of cervical spine radiculopathy.
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Cervical Radiculopathy
Cervical radiculopathy is caused by cervical nerve root compression. The patient will have pain and/or progressive neurological deficit that results from conditions such as disc herniation that irritates a nerve in the cervical spine. Cervical radiculopathy is an irritation of the cervical nerve root. Cervical spine and shoulder problems overlap. The condition is of cervical spine etiology if the patient’s symptoms are relieved by shoulder abduction, by placing the hand over the head. The relief of the symptoms occurs due to decreased tension on the nerve roots. In cervical disc problems, be aware of false positive MRIs especially if the patient is above the age of 40 years old. Nerve conduction studies are not useful; they have a high false negative rate. EMG and nerve studies may differentiate radiculopathy from peripheral nerve entrapment. Cervical disc problems usually affect the lower numbered nerve root. When you see the middle finger numbness, then this is C7. When compression of the C7 nerve root, there will be middle finger numbness, triceps weakness, and the triceps reflex will be affected. The cervical nerve roots are horizontal in orientation. It does not matter if cervical disc herniation is central or foraminal, it will compress the same nerve root. C7 nerve root runs above the pedicle of the C7 vertebra. C5-C6 is the most commonly affected disc and that will compress the C6 nerve root. The patient will come to the doctor with unilateral arm pain that is relieved by arm elevation. The numbness and paresthesia will occur in specific dermatomes. The patient may also have upper trapezius pain or interscapular pain. The patient may complain of occipital headache. When you examine the patient, do provocative tests such as the spurling’s test and the shoulder abduction test. The Spurling’s test is done by extending and rotating the neck towards the involved side. It reproduces the symptoms by narrowing the neuroforamen. The Spurling’s test differentiates cervical radiculopathy from peripheral nerve entrapment. Lifting the arm above the head relieves the symptoms if the cervical nerve roots are irritated. The Shoulder Abduction test differentiates cervical pathology from other causes of painful shoulder etiology. Make sure that you do not have a double crush syndrome, one in the neck and one in the peripheral nerve. Make sure that you differentiate radiculopathy from myelopathy. Make sure that you exclude a coexisting myelopathy. Examine the patient for upper motor neuron signs or cervical myelopathy. Test the patient for gait instability. Test the patient for Hoffman’s sign. Test the patient for Babinski reflex. Test the patient for ankle Clonus. Check to see if the patient has hyperflexia in the upper and lower extremities (triceps/quadriceps). Even if there is a bad cervical spine disc problem on the MRI, treat it conservatively for about 3 months. Give the patient therapy and nonsteroidal anti-inflammatory medication (NSAIDS). 75% of the patients will improve with nonoperative treatment. Cervical radiculopathy is generally treated nonoperatively, in contrast to cervical myelopathy. Do surgery when there is persistent, severe pain for 6-12 weeks and/or progressive neurological deficit such as weakness or numbness. The procedure to treat cervical radiculopathy surgically is usually done anteriorly with direct removal of the lesion that causes the radiculopathy such as a herniated disc or spurs. When you place the anterior bone graft or the allograft in the disc space, you open the nueroforamen, and that will indirectly relieve the nerve. Then you will add the anterior plate. Some surgeons prefer to do a posterior approach.
I don't understand how someone could dislike your videos. Great information, really practical and daily work transferable. Keep doing this, very helpful Doc!
Alberto - Thank you
Clearly one of the best teachers out there, you make such a complicated subject so easy , love those animated videos .
This is the Best Ever explanation of my hand & arm issues. Thanks SO much.
excellent way to explain the cervical radiculopathy.
thank you
Very thankful for this video. It helped me understand my condition better.
Just going through this myself, been told got to have an operation 😢
Thank you, Dr. Ebraheim for this information. It helped me understand my condition better. I am currently under physical therapy and medication because of cervical radiculopathy that causes me to have neuropathic pain. Your explanation helped me understand why I feel painful pins and needles on certain parts of my hands and back in relation to C6 and C7 as what I have also heard from my doctor. Thank you.
Doctor Ebraheim, you are amazing!! Please keep up the awesome work...I am learning so much more than from a book or even other RUclips channels. I think you were put here on earth to help people both on the operating table and beyond!! You are a natural as a teacher and you've been blessed - thanks for blessing us as well!!
You all prolly dont give a shit but does anyone know a tool to log back into an instagram account??
I stupidly lost the login password. I appreciate any assistance you can offer me
@Mathew Wesson instablaster :)
@Mathias Hunter Thanks so much for your reply. I got to the site on google and I'm trying it out atm.
I see it takes quite some time so I will reply here later with my results.
@Mathias Hunter it did the trick and I finally got access to my account again. I am so happy:D
Thank you so much you saved my ass!
@Mathew Wesson happy to help xD
Cannot thank you enough sir. You are one of the rare ones across the world who is generous and willing to teach. Gracias ❤
THANK YOU PROF. DR. NABIL FOR THIS EXCELLENT EXPLANATION 🎉🎉🎉
I appreciate your simplified explanations, now I am better prepared to discuss my options (cervical stenosis, herniated c4-c5-c-6-c7,foraminal stenosis too).
great talk but as a pain doctor i'd add a few things to treatment. First NSAIDS / anti inflammatories are often not effective for nerve pain. Try nerve pain medications such as amitriptyline/ nortriptyline, duloxetine or pregabalin/ gabapentin. Second there is the option of epidural injections / pulsed radiofrequency for symptoms that don't improve with medication before going on to surgery.
There is no speciality called pain doctor so keep your options for yourself
Thank you Dr. Ebraheim, this is a GREAT video! I wish I'd have found this 3 months ago when my condition started... Not sure it would have changed the course of my treatment, but I certainly would have been much more informed...
This was invaluable to me as someone who has been diagnosed with cervical nerve compression. It helped me make sense of my MRIs so I'm more informed of what to expect when I see my neurologist. Clear, concise, and to the point. Thank you!!!
Brilliant. I've had what I believed to be a trapped nerve in my neck for about a week. I now know the issue is likely a C6 root nerve irritation due to the dermatone affected. Amazing work!
Hi. How are you feeling now ?
Doc, thank you so much for this educational video, it helps greatly!
Two drs let me go with bone spurs (since 2018) another one over one year with a pinched nerve with a negative nerve conduction test!! Now after two ACDFs I'm going to have to get a third neck surgery. I'm glad I came across your video.... My best friend has also had a false negative nerve conduction test.. I'm a former EMT and I'm not happy with any of these two drs.
What is the solution for this?any idea? Pls help. Im dying due to pain.
@@AbcDef-fd7kg Make sure you keep this video. Get yourself a neurosurgeon or orthopedic surgeon who listens to you about your pain and will do the appropriate tests. If they are not following standard treatment for your c spine pain, get another Dr who will listen to you. This video may be the one to show them. Best to you!!
I found your information to be very helpful! Have been researching for a few months now and this is the best in explanation. Your diagrams are clear and relatable to a non medical person. Thank you.
Very informative. I been dealing with these problems for years. Never total relief injured neck wrestling in high school back in the 70,s. Retired now and only answer is surgery. Most info in such a short video. Both my sons in there forties have spine arthritis and my oldest son that is 6 ft.6 had to have plate in his neck 5 years ago with some permanent drop foot. If arthritis is in your family any spine injury at any age can come back and haunt you latter in life.
Your videos are amazing. So informative and helpful. God bless you Dr Nabil. I only wish you were my physician.
You absolutely wonderful man. Thank you, Dr.
Excellent! Thank you very much!!
Just let say your explanations are really easy to understand thank you 😊
Doctor ebraheim you are the master of being concise and precise with all of your topics once again. Thank you very much
Much appreciated - a much easy summary than what my consultant provided.
Sir..u r d best ortho teacher..tnx a lot sir..keep us uploading with many more worthful videos🙏💐
Thanks Doctor... This video is informative, thoroughly enjoyed learning from it.
Your videos are so helpful. Would you please consider producing some videos on ordering physical therapy?
Yes, very informative
Excellent explanation. Very clear. Thank you so much!
best teacher ever
Thank you Doctor for this valuable information. It is very helpful.
Thanks for your very precise information. It is very useful.
Thank you Dr Ebrahim, this video was very informative. I consulted a neurosurgeon last week and he advised me that the only way to rid the pain, would be surgery or he'll prescribed pain killers. I wasn't very happy with that and opted not to do the surgery. I'm sure with a few physical treatments, my pain will be relieved, God Willing
Which medicine you used
Rufqah the human body is capable of incredible healing abilities. I believe I have this right now from years of Jiu Jitsu and I am confident that rest and physical therapy will eventually work
Stay away from surgery.
Excellent and simplified. God bless you Dr Nabil.
This was very helpful, doctor Schwarzenegger. I went to the ER thinking I was having a stroke/heart attack cause of the arm pain, but they diagnosed me with possible cervical radiculopathy. The fact that the pain lessens when I elevate my left arm was the smoking gun. Thank u again.
Did u feel vertigo?
No!
What did you end up doing to get better? Like what treatment or treatments
Unfortunately it took months of physical therapy to make the pain finally stop. One of the worst things I’ve ever physically experienced. If you do indeed have it now stay strong and keep that arm elevated. People will think you’re constantly trying to politely ask a question but at least u feel a little better.
Thank you so much for your videos. They are so helpful!
A GREAT PRESENTATION !!! THANKS JOHN
Thank you 👍
Thanks
Thank you, crystal clear. I’m up for surgery in my neck next week🥹.
Great work Quite useful thanks 🙏
Thank you so much ..This video was very informative..I also share it with my friends..✨
You're videos helped me in ortho and even now as a provider
Extremely helpful and clear
جزاك الله خير وكتب اجرك بالعلم النافع
Great⭐⭐🥇
ان الله لا يضيع أجر من أحسن عملا ........ صدق الله العظيم
C5
Thanks very much informative video I'm a physical therapist ...
Very helpful style . God bless you sir
Thanks Dr for the very useful information.
I love your lessons they are the best!!!! :) thank you so much!!!!
Need doctor's like you mine just make me suffer & i pray everyday for God's healing cause he is are only healer anyone going through these thing's wish you all the very best on medical.
EXCELLENT INFO!!!
Glad it was helpful!
Thank you so much for posting this video!
Thank you
I love it ! More ! More ! More videos like this !
Very helpful video. Thank you!
Thank you so much for the video .It was very helpful.
My neck is shot. Herniations, foraminal stenosis, radiculopathy and other issues from C1 to C7. Shoulder joint and major trap issues. It started in my 30s and now I'm 65. It causes pain constantly, just a small movement creates shooting nerve pain. I have Ehlers Danlose, Babesia and Lymes. The last 2 were never treated because of false negatives for years. I had knee surgery at 19 and finally got it replaced in 2014. Apparently, my joints and spine create bone spurs. I had shoulder surgery in my 30s for it. I was an architect and couldn't lift my arm one day to draw.
Thanks doc I needed this so now I understand better! I’m having to be operated on as had an issue for over 7 months now 😢
I have this and the pain is no joke! Thank you for this very informative video. My Dr gave me Gabapentin and ibuprofen. 🤞🏽🙏🏽 here’s to healing!
I have the same thing going possibly. I’ve been getting Tara dip and muscle relaxers it ain’t doing shit !!!
Great explain. I got many of things to diagnose patients as a doctor
Tnank you very much sir.. God bless you for your effort
Amazing, very interesting, very knowledgeable videos
It's very helpful. Thanks
I'm having a 4 Level C-Spine fusion C3-C6 in the very near future due to ongoing severe pain. I was scheduled to have it August 16th but there was a problem with my Blood work so it was postponed. Thank you for all the good information.
I had that surgery about fifteen years ago, now my pain is fifty times worse, good luck!
@@whatsit2ya247 Sorry to hear about your pain level. I actually ended up with a 5 Level C-Spine fusion C3-C7 on September 25th. Hopefully it will work out in the end.
@@9sec93lx Yeah, hopefully.
In hindsight I probably would have had a better outcome had I not been pressured to return to work so soon, (2-3 months ?) hard physical auto body repair, after two years of that now I'm on permanent disability. So obviously please take it easy, best wishes!👍
@@9sec93lxhello, would ypu please share your experience thus far after surgery? My mum has the same condition
best explanations ever!
That was very clearly helpful
Thank you! Very well explained.
U r the bst teacher!! I seeen🙏🤩
Thank you, that was excellent!
Thank you so much for the informative video. I believe I have a greater understanding of my severe pain in scapula radiating down left arm with tingling in ring and little finger..only semi relief of constant pain was raising arm over my head. All Drs. I’ve seen keep telling me it’s T-7 herniation. I have herniation of C-4,5, C5-6, and C6-7.
Do you experience vertigo?
@@starlite7785 I do sometimes...
Thank u so much Dr ....this video very helpful to me ....u well explained 👌
Thank You!
Very useful film!
Excellent. Thank you Sir.
يعطيك العافيه جدا واضح
Thank you so much for details
I fell down and started having muscle stiffness in right trap muscle and numbness in last two fingers of right hand for first 2 months i didnt went to hospital i thought it would go away later on pain started to increase more and i visited one doctor he said that i was suffering from trapezius tendonitis and it would go away from 3rd month i started having twitchings all over body but they are not painful they would just come and go and pain wasnt going away so after 6 months from falling down i visited many doctors they all would say it is just muscle stiffness nothing serious with it and it would go away but 1 doctor suggested to go for MRI for cervical spine so i went and i found that i have mild disc bulge in c3-c4 segment, loss of cervical lordosis and multilevel partial disc changes so pain from right hand has spread to left hand as well and i even went to massages for pain relief for almost 5-6 sittings , no other symptoms are there and my vitamin D level, vitamin b12 levels are good and i even went for thyroid blood test it is also good as of now pain almost seems to be gone in both hands but few times my last two fingers go numb after waking up from sleep in both hands and muscle twitchings are still there and they are coming all over body. Can anyone please suggest what should i do now..?
I will be so glad when I have surgery next month, this pain is killing me and I’m tired of taking muscle relaxers and pain meds
Thanks!
Thank you very much for the gift
Easy to understand
Hello Doctor, while lifting my left arm I have severe pain on forearms & triceps. Sometimes feel more pain on my neck left side nerve, interscapular area, Occipital headache and peripheral nerve pain. But no numbness on middle finger. My doctor prescribed me some NSAIDs and some excercise only. In MRI result "Mild left foraminal bulge with subtle exiting nerve root impingement at C5 -C6 level. No cord compression"
Canal dimensions from C2 to C7 levels.
C2-C3 10.4 mm
C3-C4 10.6 mm
C4-C5 11.2 mm
C5-C6 9.5 mm
C6-C7 7.4 mm
C7-D1 9.1 mm
Very helpful! Keep making videos please!!!!!!!!!
Video Thật tuyệt vời .Cảm ơn bác sĩ.
Right Arm lower than Left
Neck Pain Radiating to Left Arm
pulsations in body
Head Jerks Suddenly(rarely)
Dizziness(When Eyes Closed During Sitting)
Very good content Dr.
U R The best in the world 👑
Heartly thank you doctor,
Thank you! Can you please advise on the exercises to treat the issue is in C6, C7. thanks again.
Thank you Dr Nabil Ibrahim very good work jazzak Allah . I'm from Pakistan 🇵🇰
It's very helpful
Thank you for your effort 💖
Good morning sir aap ka sara video mein dekhta hoon bahut hi accha samjhe Te Hain sir thanks sir kripya Hindi me Bataye
Thanks for your clear explanations. I have some on and off numbness in left hand, left leg and left side of the lip. I can even provoke it to appear, now I can start to detect where it comes from by your great instructions :-)
What was it ? I have the same symptoms
It had to be a trapped nerve I took some long walks and did some simple Chigong exercises and a week after it was gone.
@@hbjensen2011 are the nerves of the leg and hand connected ? I have lack of information about that m
@@triptijoshi7937 how are you i am suffering fron same
About branchial plexus injury from C5-T1
EXCELLENT. THANK YOU FOR SHARING.
Thank you so much doctor… 🙏
شكرا لجهودك
Thank you so much! New DPT here 🤩
What test is that. I am so annoyed with my docs not treating me well.
Yes very helpful. Thank you.
Please advise Using a firm pillow along with the Tuck Chin exercises should be fine to heal this issue ???
thankyou
thank you so much
But what when effects the legs , walking , weakness and instability? Help