Neck Pain Accompanied by Arm Numbness
Table of Contents
Overview of cervical radiculopathy
Cervical radiculopathy is a condition in which a nerve root emerging from the cervical spine is compressed or irritated, producing pain, numbness, and muscle weakness along the path supplied by that nerve from the neck down to the arm and hand. The most common causes are cervical disc herniation and degenerative bone spurs that narrow the neural foramen. In Korean medicine, it is regarded as a manifestation of bi-syndrome (痺證) in the upper limb due to obstruction of qi and blood in the meridians.
Differentiation by dermatome
- C5 nerve root: Lateral shoulder pain, deltoid weakness, and difficulty lifting the arm to the side.
- C6 nerve root: Numbness in the thumb and index finger, weakness of wrist extension, and decreased biceps reflex.
- C7 nerve root: Numbness of the middle finger, weakness of finger extension and wrist flexion, and decreased triceps reflex.
- C8 nerve root: Numbness of the ring and little fingers, decreased grip strength, and impaired fine motor function.
Differentiation from thoracic outlet syndrome
Not every cause of arm numbness lies in the cervical spine. Thoracic outlet syndrome (TOS) produces similar symptoms when the brachial plexus or subclavian vessels are compressed between the clavicle and the first rib. Symptoms worsen when the arm is raised overhead, and pallor or coldness of the hand suggests vascular TOS. Differentiation is made using the Adson test, Roos test, and others.
Korean medicine treatment
- Acupuncture: Needling is performed on the Jiaji points (夾脊穴) of the affected segment and on acupoints of the relevant meridians. Upper-limb points such as Jianyu (LI15), Quchi (LI11), and Hegu (LI4) are added to promote meridian flow.
- Pharmacopuncture: Anti-inflammatory pharmacopuncture is administered around the nerve root to directly reduce nerve edema and create an environment conducive to nerve regeneration.
- Chuna manipulation: Cervical segments are corrected in the direction that widens the neural foramen, reducing physical compression.
- Herbal medicine: Boyanghwano-tang (補陽還五湯) modified with notopterygium (羌活) and clematis (威靈仙) is prescribed to assist functional recovery of the upper-limb nerves.
Prognosis and management
About 80–90% of cervical radiculopathy cases improve with conservative treatment. However, surgical evaluation is required if progressive muscle weakness or gait disturbance develops. During the treatment period, it is important to avoid using a high pillow and to minimize prolonged forward-head postures.