A pinched nerve in the neck can be very painful. However, some treatments — such as physical therapy and immobilizing the neck — can help ease pain and relieve pressure on the nerve.
A pinched nerve occurs when a nerve becomes irritated or compressed. The medical term for when this happens in the neck is cervical radiculopathy.
This article explains what may cause a pinched nerve, how doctors diagnose it, what types of treatment can help, and when to contact a doctor.
The upper end of the spine has seven small bones, or vertebrae, that begin at the bottom of the skull and end at the shoulders. These seven vertebrae make up the cervical spine.
Nerves branch out from the spinal cord and exit through small openings between the vertebrae called foramen.
When these nerves become irritated or compressed, it can result in neck pain and sometimes pain, numbness, or tingling that runs down the arm into the hand.
A pinched nerve in the neck may cause the following symptoms:
- pain in the neck
- numbness or tingling in the arm and hand
- weakness in the shoulder, arm, hand, or all three
- loss of sensation in the arm, hand, or both
It is also common for any of the above symptoms to occur with movement of the neck.
Typically, to reach a diagnosis, doctors will ask about symptoms and then examine the neck, shoulders, arms, and hands.
Oftentimes, they will also ask the person to move their arms and neck to see where they are experiencing weakness or pain.
There are several tests that doctors can perform to help them diagnose a pinched nerve in the neck.
The Spurling test
The Spurling test involves extending the neck, rotating the head to the side where the symptoms occur, and applying gentle downward pressure to the top of the head.
An X-ray is one type of imaging tests that can aid in the diagnosis of a pinched nerve in the neck.
An X-ray can show the alignment of the vertebrae in the neck. It can also demonstrate narrowing of the foramen and disc spaces between the vertebrae.
Computerized tomography (CT) scans show bone in more detail than an X-ray. Sometimes, doctors order them in the workup of a person with a suspected pinched nerve.
With the use of magnetic resonance imaging (MRI), doctors can see the vertebrae, soft tissues, and nerves in greater detail than with other scan types.
MRI scans can show how severe the nerve compression in the neck is. They will also allow doctors to see whether a herniated disk is causing compression of the nerve or the spinal cord.
An electromyelography (EMG) test measures the speed of transmitting electrical impulses along a nerve. Sometimes, doctors will order this test to determine whether a nerve or group of nerves is functioning properly.
In the case of a suspected pinched nerve in the neck, an EMG can help doctors determine which nerve has become irritated or compressed and where exactly the compression occurs.
According to a 2016 study, age-related degeneration of the intervertebral disks is the main cause of cervical radiculopathy.
As the disks degenerate, their height decreases, and the foramen — the holes in between the vertebrae where the nerves from the spinal cord exit — narrow.
Disk degeneration places excess pressure between the disks and on the nerve roots, and this process can lead to a pinched nerve.
The same study also showed that risk factors for developing cervical radiculopathy include:
- lifting heavy weights frequently
- using driving equipment that vibrates
- playing golf
The National Institute for Health and Care Excellence state that people aged 50–54 years are more likely to experience cervical radiculopathy and that it is more common in males than females.
For many people, pain from a pinched nerve in the neck will resolve on its own within 4 weeks.
However, it is common for the symptoms of a pinched nerve in the neck to return over time.
If the symptoms of cervical radiculopathy do not clear up, there are nonsurgical and surgical treatments available.
A soft cervical collar can help minimize the amount of movement in the neck and thus reduce irritation of the nerve root.
However, a person should not wear a cervical collar for more than
Physical therapy can help with a pinched nerve in the neck. Exercises aim to strengthen and stretch the neck muscles, thereby improving flexibility.
Sometimes, traction can help gently stretch the joints in the neck and relieve pressure on the nerve.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a type of pain relievers. They can reduce pain if the pinched nerve becomes irritated or inflamed. NSAIDs are widely available, and a person can purchase them from a pharmacy without a prescription.
Steroid injections use anti-inflammatory medication to ease pain. Doctors may offer a person a steroid injection if an MRI scan has confirmed a pinched nerve in the neck and if other treatments have not proven helpful.
Steroid injections can be very effective in providing long-term pain relief in people with cervical radiculopathy.
Surgical options vary depending on the cause of the pinched nerve.
Surgery aims to relieve pressure on the affected nerve and, in some cases, improve the alignment of the cervical spine.
Anterior cervical discectomy and fusion
The aim of anterior cervical discectomy and fusion (ACDF) is to remove the disk or bone spurs causing nerve compression.
During the procedure, the surgeon removes the disk and bone spurs causing the compression. They then fuse the two affected vertebrae together, which stabilizes the damaged part of the cervical spine.
Artificial disk replacement
This procedure involves removing the herniated disk and replacing it with an artificial disk made of metal or plastic.
Posterior cervical laminoforaminotomy
This procedure shaves down the back of the spinal canal and removes any bone, bone spurs, tissues, and disk material that may be causing a pinched nerve.
Sometimes, it is possible to treat a pinched nerve in the neck at home with any of the following:
Cervical traction devices are also available for use at home.
It is advisable to call a doctor if symptoms do not clear up after 4 weeks or if a person experiences any of the following symptoms:
- stiffness in the neck
- nausea or vomiting
- unexplained weight loss
- vision problems
- severe headaches
- sensitivity to light or sound
- altered mental state
These symptoms may indicate a more serious problem with the spine and may require further tests and treatment.
According to an article in the journal American Family Physician, most people will recover from a pinched nerve in the neck, and 88% of people will get better within 4 weeks and not require surgery.
However, in more severe cases, nerve damage may not improve, and people may need more significant treatment.
A pinched nerve in the neck is a common problem and can be very painful. However, it often clears up within a few days or weeks.
There are many nonoperative treatments, such as rest, medication, and physical therapy, that a person can try before a doctor decides they need surgery.