Case study: Cervical radiculopathy – Injection
A 50-year-old woman presented with radicular pain in her right upper limb that has persisted for 3 weeks and becomes especially severe at night. She hasn’t had any recent fever or injury incidents. However, she did lift a substantial weight recently. There have been no past episodes of similar pain. NSAIDs and gabapentin have been ineffective in alleviating her discomfort.
Physical examination
- The pain started in the patient’s neck with severe pain around the shoulder, which radiated along the entire arm
- No aggravating or relieving factors
- No limb edema or wasting of small muscles of the hand
- The shoulder appeared normal during clinical examination
- Jackson’s compression test: Positive
- Spurling’s test: Positive
Imaging
- X-ray: Early cervical spondylosis, indicated by osteophytes, facet degeneration, and foraminal narrowing.
X-ray imaging of the cervical spine revealed early cervical spondylosis, indicated by osteophytes, facet degeneration, and foraminal narrowing.
- MRI: A paramedian disc bulge was identified at C5-C6, impinging on the anterior thecal sac. Another paramedian disc bulge was noted at C4-C5, but it probably isn’t the primary cause of significant symptoms.
MRI imaging revealed paramedian disc bulges at the C4-5 and C5-6 levels.
Diagnosis
The patient was diagnosed with C5 radiculopathy on the right side. Cervical radiculopathy occurs when nerve compression arises due to herniated discs or arthritic bone spurs. Symptoms like peripheral radiating pain, muscle weakness, or a tingling sensation can usually be linked to the specific impacted nerve root.
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