Cervical Radicular Pain

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Limb Pain

Based off data from Rainville et al. [1] The asterix indicates the only area where there is a statistical difference, with impaired in the distal radial aspect of the dorsal forearm more common in C6 than C7 radiculopathy.

It is not possible to distinguish C6 from C7 radiculopathy with a sensory examination of the so-called dermatomes.

Shoulder Girdle Pain

(a)C5 and C8 cutaneous nerves traverse up and down the spine of the scapula, respectively, whereas the courses of C6 and C7 cutaneous nerves are not found.
(b) The site of radicular pain involving the C6 root overlaps with that of the C5 root, and also involves the posterior deltoid.[2]

Scapular and shoulder pain can occur with cervical nerve root irritation. This is analogous to the common finding of buttock pain with lumbar radicular syndrome. Scapular pain usually precedes pain in the arm and/or fingers. The site of scapula pain may be a helpful data point in determining the affected level, but it is important to consider the more common cervical facet joint pain. Scapula pain may occur through the medial branches of the dorsal rami of the cervical nerves. Mizutamari et al found that there was no cutaneous course of C6 and C7 and that these patients complained of deep scapula pain only. This is compared to patients with C5 and C8 lesions having both superficial and deep pain.[2]

Mizutamari et al found the following pain referral pattern:

Nerve root Shoulder Girdle Region Deep or superficial
C5 Suprascapular region Superficial and deep pain
C6 Suprascapular to posterior deltoid region Deep pain
C7 Interscapular region Deep pain
C8 Interscapular and scapular regions Superficial and deep pain

References

  1. โ†‘ Rainville et al. Exploration of sensory impairments associated with C6 and C7 radiculopathies. The spine journal : official journal of the North American Spine Society 2016. 16:49-54. PMID: 26253986. DOI.
  2. โ†‘ 2.0 2.1 Mizutamari et al. Corresponding scapular pain with the nerve root involved in cervical radiculopathy. Journal of orthopaedic surgery (Hong Kong) 2010. 18:356-60. PMID: 21187551. DOI.

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