Cervical Radicular Pain
It is not possible to distinguish C6 from C7 radiculopathy with a sensory examination of the so-called dermatomes.
Shoulder Girdle Pain
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.
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|
- 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.
- 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.