Common Clinical Presentation: (6)
C4:
· Unexplained neck and shoulder pain
· Numbness extending from the caudad aspect of the neck to the superior aspect of the shoulder
· Difficulty breathing during exercise
C5:
· Presents with numbness in an “epaulet” distribution
· Beginning at superior aspect of the shoulder and extending laterally to the mid-part of the arm
C6:
· Pain and/or numbness radiating from the neck to the lateral aspect of the biceps, down the lateral aspect of the forearm, to the posterior (dorsal) aspect of the web space between the thumb and index finger and into the tips of those digits
C7:
· Pain radiating along the back of the shoulder, extending into the scapular region, down along the triceps, along the posterior aspect of the forearm and into the posterior aspect of the long finger
Diagnosis: (2,5)
- Patient will present with a stiff neck and have a head list away from the side of injury
- Pain with AROM usually with extension, rotation and side bending toward the symptomatic side
- Varying degrees of sensory, motor and reflex changes as well as dysesthesias and paresthesias related to nerve root(s) without evidence of spinal cord dysfunction (myelopathy)
DDx: (2,6)
- Brachial Plexus disorders
- Pathologic shoulder conditions- will have pain with ROM of the shoulder impingement signs, if C5 radiculopathy patient will present with absence of these things
- Peripheral nerve entrapment or compression within the upper limb
-Median nerve –Present similar to C6-7 radiculopathies
-Ulnar nerve-Present similar to TOS and C8 radiculopathy but will not involve weakness in the flexor digitorum profundus in the index and long
fingers and flexor pollicis longus in the thumb
- Myofascial etiology- pain in the posterior neck with flexion-173
- Muscular strain of the sternocleidomastoid- Anterior neck pain during rotation to the contralateral side-173
- Pathological changes in upper cervical spine- Severe pain in suboccipital region and radiate to back of ear or lower neck and rotation restricted
- Other pathologies- Schwannomas, meningiomas, benign/malignant vertebral body tumors or pancoast tumors