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Back| Disc | Cervical Nerve Root | Symptoms and Signs |
|---|---|---|
| C2-3 | C3 | Pain and numbness in the back of the neck, especially around the mastoid and auricle. No muscle weakness or reflex changes. |
| C3-4 | C4 | Pain and numbness in the back of the neck radiating along the levator scapulae, with radiation to the anterior chest. No muscle weakness or reflex changes. |
| C4-5 | C5 | Radiating pain along one side of the neck and shoulder, numbness in the deltoid area. Deltoid muscle weakness and atrophy, no reflex changes. |
| C5-6 | C6 | Radiating pain along the lateral side of the upper arm and forearm to the thumb and index finger, thumb tip. Numbness in the first dorsal interosseous muscle of the hand. Weakness and decreased reflex of the biceps muscle. |
| C6-7 | C7 | Radiating pain along the central dorsal side of the upper arm and forearm to the middle finger, may also involve the index and ring fingers. Weakness and decreased reflex of the triceps muscle. |
| C7-T1 | C8 | Radiating pain along the medial side of the forearm to the ring and little fingers. Numbness on the ulnar side of the ring and little fingers. Atrophy and weakness of the interosseous and lumbrical muscles, no reflex changes. |
Explanation
Due to cervical spine degeneration, compression or traction of the spinal nerve causes radicular symptoms. These manifest as radicular or plexus pain consistent with the affected nerve, along with sensory disturbances, hypoesthesia, and hyperesthesia. Muscle strength decreases in the innervated area, with atrophy most evident in the thenar and interosseous muscles. Upper limb tendon reflexes are diminished or absent. Stimulation of the sinuvertebral nerve endings in the spinal nerve root sheath causes neck pain. When the cervical disc and osteophytes compress the nerve root, there is significant neck and upper limb pain. The highest incidence is in C4-5, C5-6, and C6-7, with patients presenting with neck and shoulder pain, radial forearm pain, and radial three-finger pain. The neck compression test is positive, indicating radicular pain.
