From the Guidelines
C7 radiculopathy typically presents with pain, numbness, and tingling that radiates from the neck down the arm into the middle finger, along with weakness in the triceps muscle and diminished triceps reflex. The symptoms of C7 radiculopathy can vary in severity and impact on daily life, but generally include:
- Pain in the neck and arm
- Numbness or tingling in the arm or hand
- Weakness in the triceps muscle
- Diminished triceps reflex Treatment options for C7 radiculopathy focus on relieving symptoms and improving quality of life, and may include:
- Conservative measures such as rest, activity modification, and over-the-counter pain medications like ibuprofen (400-800mg three times daily) or naproxen (500mg twice daily) for 1-2 weeks 1
- Physical therapy focusing on neck strengthening and posture correction for 6-8 weeks
- For moderate pain, muscle relaxants like cyclobenzaprine (5-10mg three times daily for 1-2 weeks) may help, while severe pain might require a short course of oral steroids such as prednisone (starting at 60mg daily and tapering over 5-7 days)
- Epidural steroid injections can be considered if pain persists beyond 6 weeks, as recommended by the British Pain Society's pathway for care 1 The British Pain Society's pathway for care emphasizes a stepped care approach, empowering patients to make informed choices regarding available treatment options, and recommends early assessment and referral to specialist services for patients with severe radicular pain or neurological deficits 1. Most cases of C7 radiculopathy resolve with conservative treatment within 4-6 weeks, but persistent symptoms with neurological deficits or intractable pain may necessitate surgical intervention such as anterior cervical discectomy and fusion. The cause of C7 radiculopathy is often related to compression or irritation of the C7 nerve root, commonly due to disc herniation, foraminal stenosis, or degenerative changes in the cervical spine, disrupting normal nerve function and causing the characteristic symptoms 1.
From the Research
Symptoms of C7 Radiculopathy
- Pain in the neck and radiating arm pain or numbness 2, 3
- Sensory deficits or motor dysfunction in the neck and upper extremities 2, 3
- Scapular winging, apparent either in the usual position or the modified position, due to weakness of the serratus anterior muscle 4
- Numbness or tingling in areas innervated by the affected nerve root 3
Treatment Options for C7 Radiculopathy
- Nonoperative management, including cervical collars, traction, and medications to alleviate pain and neuropathic symptoms 2
- Physical therapy and manipulation to improve neck discomfort 2, 3
- Selective nerve blocks to target nerve root pain 2, 3
- Guided corticosteroid injections to control nerve root pain 3
- Multimodal approach to treatment, including a combination of the above options 2, 3
- Surgical management may be necessary in some cases, especially when there are anatomical anomalies such as a congenital low-set C7 pedicle 5