By Mr Ahmed-Ramadan Sadek, Neurosurgeon · Last reviewed October 2026 · 7 min read

What is cervical radiculopathy?

Your neck (the cervical spine) contains seven vertebrae. Between each pair sits an intervertebral disc, a cushion with a tough outer ring and a softer, jelly-like centre that keeps the bones apart and absorbs jolts.

At every level, a nerve root leaves the spinal canal through a small opening at the side and travels into the shoulder, arm and hand. These nerves carry instructions to your muscles and send back information about touch, temperature and pain.

Radiculopathy simply means a problem with a nerve root. In the neck it is most often caused by a disc that has bulged or split (a disc prolapse or herniation), or by a bony outgrowth called an osteophyte, pressing on one of these nerves. It is sometimes described as the arm’s equivalent of sciatica.

Why does it happen?

With age, discs gradually dry out and lose their spring. The outer ring can develop small tears, letting some of the softer centre squeeze outwards, much like a slipped disc in the lower back. Wear in the small neck joints can also produce bony spurs. Either can crowd the narrow tunnel a nerve root passes through, often without any particular injury.

Symptoms

• Sharp, shooting or burning pain travelling from the neck into the shoulder, arm or hand
• Pins and needles, numbness or unusual sensitivity of the skin
• Weakness of particular arm or hand muscles
• Neck stiffness or ache, although arm symptoms are usually the main complaint

Which part of the arm is affected depends on which nerve is squeezed. A problem high in the neck tends to cause shoulder symptoms, whereas lower levels may produce tingling in particular fingers.

How is it diagnosed?

Your specialist will ask about your symptoms and examine your arms, testing strength, sensation and reflexes. An MRI scan is the usual test to show which disc or spur is responsible and how much room the nerve has. It is important that scan findings match your symptoms, because disc changes are very common in people without any pain.

Treatment without surgery

The outlook without an operation is generally good. Over time the bulging disc material can shrink and the inflammation around the nerve can calm down. BASS patient information notes that roughly 6 out of 10 people improve on their own within six weeks, and 7 to 8 out of 10 by three months.

While you wait for this to happen, the following can help:

• Staying gently active and avoiding long periods in one position
• Regular pain relief, which may include medicines aimed specifically at nerve pain
• Physiotherapy to maintain movement and posture
• An image-guided steroid injection around the nerve, which can reduce swelling and ease pain (see our guide to nerve root injections)

When is surgery considered?

Only a small proportion of people with a neck disc prolapse need an operation. Surgeons rarely operate within the first 6 to 8 weeks, because so many people improve naturally during that time. Surgery becomes a reasonable option when severe arm pain persists despite strong pain relief, or earlier if there is clear or increasing weakness or numbness, to give the nerve the best chance of recovering.

The goal is to relieve arm symptoms, not to stop the natural ageing of the spine. According to BASS patient information, good relief of arm pain is achieved in about 85 to 90 in 100 people, although improvement may build up over several weeks. Numbness or weakness may not fully recover, even after a technically successful operation, and neck pain alone is not a reason for this type of surgery.

Anterior cervical discectomy and fusion (ACDF)

This is the most common operation. Through a small cut at the front of the neck, the windpipe and gullet are gently moved aside to reach the spine. The surgeon removes the problem disc and any bony spurs, freeing the nerve. The empty space is then filled with a small spacer (a cage) and/or bone graft so that the two vertebrae knit together into one solid unit. This joining, called fusion, usually takes around 3 to 6 months. A small titanium plate is sometimes added for extra support.

Anterior cervical disc replacement (ACDR)

For suitable patients with healthy surrounding joints and good bone strength, the disc can be replaced with an artificial one instead of being fused. This preserves some movement at that level (BASS literature quotes about 5 to 8 degrees). It may lessen strain on neighbouring discs, but it is a newer technique, the device could in theory wear over time, and it is not suitable for people with arthritis in the neck or osteoporosis.

Posterior cervical foraminotomy

Working from the back of the neck, the surgeon removes a little bone to widen the opening the nerve passes through, sometimes via a narrow tube. It is often chosen when someone has previously had surgery at the front of the neck.

Risks and complications

All operations carry some risk, and your surgeon will discuss how these apply to you. The figures below come from BASS patient information on surgery for cervical disc protrusion.

Risk	Approximate frequency (BASS)
Nerve root injury (first operation)	Less than 1 in 100
Nerve root injury (repeat operation)	Up to 10 in 100
Tear in the nerve lining (dura)	Fewer than 1 in 100
Further surgery to repair a fluid leak	Less than 0.05%
Superficial wound infection	Up to 4 in 100
Deep wound infection	Fewer than 1 in 100
Blood clot in the leg or lung (DVT/PE)	Fewer than 1 in 100
Bone not fusing (non-union)	Up to 5 in 100
Cage, graft or artificial disc shifting (front approach)	Up to 2 in 100; about 1 in 100 need re-operation
Injury to windpipe or gullet (front approach)	Fewer than 1 in 100
Drooping eyelid, usually temporary (front approach)	Less than 1 in 100
Death from major blood vessel injury	About 1 in 10,000
Fatal general anaesthetic complication	About 1 in 250,000

Other possible problems, without a precise figure, include temporary hoarseness or difficult swallowing after front-of-neck surgery, bleeding causing neck swelling, recurrent arm pain from scarring and, very rarely, spinal cord injury or stroke. In later years, neighbouring levels can also wear and cause new symptoms.

Recovery after surgery

Most people go home the day after surgery. Arm symptoms can fluctuate for a while as the nerve settles, and full improvement may take up to eight weeks or longer. Do not stop strong painkillers or nerve-pain medicines abruptly; reduce them gradually with your GP’s guidance.

• Driving: usually after 2 to 4 weeks, once you can turn your head freely and perform an emergency stop.
• Work: typically 3 to 4 weeks off, or up to eight weeks for physically demanding jobs.
• Activity: walk regularly, avoid heavy lifting and reaching overhead in the early weeks, and check with your team before returning to sport.
• Flying: your surgeon may advise waiting six weeks, and up to three months for long-haul flights, because of the clot risk.

• BASS patient booklet: Cervical Disc Protrusion and Radiculopathy
• NHS: Neck pain
• Spinemathema: Nerve root injections
• Spinemathema: MRI scanning of the spine

This guide is general information and is not a substitute for advice about your own situation. Please speak to your GP or specialist.