Pain in the neck or scapular area radiating down the arm typically indicates nerve compression in the cervical spine, which can also lead to numbness or weakness. In some cases, compression of the spinal cord may affect hand function, cause difficulty in walking, and result in an unsteady gait, known as ataxia. Predominant causes include:

  • Cervical disc herniation, commonly known as a slipped disc
  • Cervical spondylosis with radiculopathy
  • Cervical spondylosis with myelopathy

In a smaller percentage of cases, these symptoms may be due to:

  • Ossification of the Posterior Longitudinal Ligament (OPLL)
  • Fractures in the cervical spine
  • Infections in the spine
  • Spinal tumours

Symptoms to Look Out For

The severity of pain can vary from mild to severe.

  • Symptoms of Nerve Compression: Pain starting in the neck or scapular region and radiating down the arm, reaching the upper arm, elbow, forearm, wrist, or hand, often accompanied by numbness or weakness.
  • Symptoms of Spinal Cord Compression: This urgent medical condition may manifest as impaired hand function, difficulties with walking, a lack of balance (ataxia), and numbness or weakness in the arms and legs.
  • Combined Compression: Some individuals might experience symptoms of both nerve and spinal cord compression.

Diagnosis and Investigations

To diagnose the cause of nerve and spinal cord compression in the neck, a Magnetic Resonance Imaging (MRI) scan is commonly performed. An MRI reveals detailed information about the pathology, exact location, and severity of the compression. Sometimes, this is complemented with a plain X-ray.

Treatment Options

Treatment depends on the cause and severity of the nerve compression and generally includes:

  • Lifestyle adjustments
  • Medication
  • Physiotherapy
  • Epidural steroid injections
  • Surgical intervention, when indicated