What types of spine conditions are the most painful?

CERVICAL RADICULOPATHY

Cervical radiculopathy, commonly called a “pinched nerve” occurs when a nerve in the neck is compressed or irritated where it branches away from the spinal cord. This may cause pain that radiates into the shoulder, as well as muscle weakness and numbness that travels down the arm and into the hand.

Cervical radiculopathy is often caused by “wear and tear” changes that occur in the spine as we age, such as arthritis. In younger people, it is most often caused by a sudden injury that results in a herniated disc (AAOS, 2015).

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SYMPTOMS

Cervical radiculopathy most often arises from degenerative changes that occur in the spine as we age or from an injury that causes a herniated, or bulging, intervertebral disc.

In most cases, the pain of cervical radiculopathy starts at the neck and travels down the arm in the area served by the damaged nerve. This pain is usually described as burning or sharp. Certain neck movements—like extending or straining the neck or turning the head—may increase the pain. Other symptoms include:

  • Tingling or the feeling of “pins and needles” in the fingers or hand
  • Weakness in the muscles of the arm, shoulder, or hand
  • Loss of sensation

Some patients report that pain decreases when they place their hands on top of their head. This movement may temporarily relieve pressure on the nerve root.

TREATMENT

Nonsurgical treatments for cervical radiculopathy include using a soft cervical collar, medications, and physical therapy. If after a period of time nonsurgical treatment does not relieve your symptoms, your doctor may recommend surgery.

There are several surgical procedures to treat cervical radiculopathy. The procedure your doctor recommends will depend on many factors, including what symptoms you are experiencing and the location of the involved nerve root.

The most commonly performed surgical procedures to treat cervical radiculopathy are:

  • Anterior Cervical Discectomy and Fusion (ACDF)
  • Artificial Disc Replacement (ADR)
  • Posterior Cervical Laminoforaminotomy

Cervical  spine conditions might be need for anterior cervical discectomy and fusion

PREVENTION

Prevention of cauda equina syndrome is focused on early diagnosis by identifying the symptoms described above. While low back pain with leg pain and/or weakness is a common complaint that affects many people, cauda equina syndrome is a rare complication. Doctors should be vigilant in identifying these cases. People should be educated on signs and symptoms that could suggest possible cauda equina syndrome, including change in bowel or bladder function and loss of sensation in the groin.

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