TY - JOUR
T1 - 2. Cervical radicular pain
AU - Peene, Laurens
AU - Cohen, Steven P
AU - Brouwer, Brigitte
AU - James, Rathmell
AU - Wolff, Andre
AU - Van Boxem, Koen
AU - Van Zundert, Jan
N1 - © 2023 The Authors. Pain Practice published by Wiley Periodicals LLC on behalf of World Institute of Pain.
PY - 2023/9
Y1 - 2023/9
N2 - Introduction: Cervical radicular pain is pain perceived in the upper limb, caused by irritation or compression of a cervical spine nerve, the roots of the nerve, or both. Methods: The literature on the diagnosis and treatment of cervical radicular pain was retrieved and summarized. Results: The diagnosis is made by combining elements from the patient's history, physical examination, and supplementary tests. The Spurling and shoulder abduction tests are the two most common examinations used to identify cervical radicular pain. MRI without contrast, CT scanning, and in some cases plain radiography can all be appropriate imaging techniques for nontraumatic cervical radiculopathy. MRI is recommended prior to interventional treatments. Exercise with or without other treatments can be beneficial. There is scant evidence for the use of paracetamol, nonsteroidal anti-inflammatory drugs, and neuropathic pain medications such as gabapentin, pregabalin, tricyclic antidepressants, and anticonvulsants for the treatment of radicular pain. Acute and subacute cervical radicular pain may respond well to epidural corticosteroid administration, preferentially using an interlaminar approach. By contrast, for chronic cervical radicular pain, the efficacy of epidural corticosteroid administration is limited. In these patients, pulsed radiofrequency treatment adjacent to the dorsal root ganglion may be considered. Conclusions: There is currently no gold standard for the diagnosis of cervical radicular pain. There is scant evidence for the use of medication. Epidural corticosteroid radicular pain pulsed radiofrequency adjacent to the dorsal root ganglion may be considered.
AB - Introduction: Cervical radicular pain is pain perceived in the upper limb, caused by irritation or compression of a cervical spine nerve, the roots of the nerve, or both. Methods: The literature on the diagnosis and treatment of cervical radicular pain was retrieved and summarized. Results: The diagnosis is made by combining elements from the patient's history, physical examination, and supplementary tests. The Spurling and shoulder abduction tests are the two most common examinations used to identify cervical radicular pain. MRI without contrast, CT scanning, and in some cases plain radiography can all be appropriate imaging techniques for nontraumatic cervical radiculopathy. MRI is recommended prior to interventional treatments. Exercise with or without other treatments can be beneficial. There is scant evidence for the use of paracetamol, nonsteroidal anti-inflammatory drugs, and neuropathic pain medications such as gabapentin, pregabalin, tricyclic antidepressants, and anticonvulsants for the treatment of radicular pain. Acute and subacute cervical radicular pain may respond well to epidural corticosteroid administration, preferentially using an interlaminar approach. By contrast, for chronic cervical radicular pain, the efficacy of epidural corticosteroid administration is limited. In these patients, pulsed radiofrequency treatment adjacent to the dorsal root ganglion may be considered. Conclusions: There is currently no gold standard for the diagnosis of cervical radicular pain. There is scant evidence for the use of medication. Epidural corticosteroid radicular pain pulsed radiofrequency adjacent to the dorsal root ganglion may be considered.
U2 - 10.1111/papr.13252
DO - 10.1111/papr.13252
M3 - (Systematic) Review article
C2 - 37272250
SN - 1530-7085
VL - 23
SP - 800
EP - 817
JO - Pain Practice
JF - Pain Practice
IS - 7
M1 - 13252
ER -