Nerve root compression

This can cause pain in the neck and down the arms.

Symptoms
Symptoms include pain in the neck which may come on after a relatively simple or minor movement.

The pain usually radiates into the shoulder area and sometimes down the arm. Neural symptoms such as tingling, numbness and decreased sensation may be felt in the arm or hand.

Weakness of the arm or hand muscles is another common symptom.

Causes

Acute nerve root compression is most often caused by a herniated disc (also known as a prolapsed or slipped disc). In-between the body of each vertebrae is a vertebral disc which helps provide cushioning and shock absorption for the spine.

Intervertebral discs consist of an outer fibrous ring, the annulus fibrosus, which surrounds an inner gel-like centre, the nucleus pulposus.

The annulus fibrosus consists of several layers of fibrocartilage made up of both type I and type II collagen. Type I is concentrated towards the edge of the ring where it provides greater strength.

The stiff layers can withstand compressive forces. The fibrous intervertebral disc contains the nucleus pulposus and this helps to distribute pressure evenly across the disc. This prevents the development of stress concentrations which could cause damage to the underlying vertebrae.

It is this which can become herniated through a defect in the external layers. The herniated nucleus then applies pressure to the nerve roots, as they exit the spine.

In older people with nerve root compression, the cause may be an osteophyte applying pressure on the nerve.

An osteophyte is an overgrowth of bone, due to repetitive stress, friction or degeneration of the disc. They may also be known as bone spurs.

Physiotherapy treatment
* They use specific mobilisation techniques on the vertebrae and nerve tissue.
* Aids like a soft neck collar may be provided.
* Soft tissue work may be done as muscle tends to tighten due to pain and protective function.
* Extension exercises are advised to encourage the herniated disc to return back to normal.
* If the symptoms don’t improve, a referral to a neurosurgeon is recommended where a MRI scan may be requested.
* Surgery to repair the herniated disc may be performed in those with long-standing symptoms or whose symptoms are especially severe.

  AUTHOR
Jeandré Theunissen

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