Cervical Root Syndrome

Cervical Root Syndrome is an impact of emphasis or strangulation cervical nerve roots by protrusion of discus invertebralis so that occur stretch of nerve roots, with the characteristics of neck pain that spreads to the shoulders, upper arms or fore arms, also experience of parasthesia, weakness and muscle spasms.

In this condition occurs the flow resistance of bloodvessels and if let will cause damage to nerve root fibers.

The cause ofcervical root syndrome is the age, body posture position that is not true,trauma and other things that cause irritation on nerve root. One of type cervikal root syndroma is radikulopati syndrome ( radiks of posterior and anterior that experience of pathological process ).

The symptoms that appear in people with cervical root syndrome during inspection and palpation are :

• Stiff pain on neck
• Pain and thick that spread to thumb and radial side of thehand
• There are weakness on the biceps or triceps
• Decrease of biceps reflex
• There are referred pain on vague shoulder, with pain of shoulder felt only in the deltoid area lateral and upper infrascapula.

The firmness of diagnosis for possibility of cervical root syndrome need to do some special inspection, including :

1. Provocation test 

Spurling test or compression for aminal test , done by extension of neck position and head rotated to one side, and provide down ward pressure on the apex of head. Result positive when there is pain of radikuler which spread onthe extremities of ipsilateral according with the direction of head rotation.This examination is very specific but not sensitive to detect cervical radikulopati.

2. Head distraction test

The distraction head will eliminate pain that caused by compression of nerveradiks. This can be shown if the suspicion of nerve roots irritating more is giving of symptoms with head compression test although other causes can not be removed.

3. Action valsalva

With this test so that can occur increase intrathecal pressure , when there is process demand space in the canal of cervical vertebral, then with boosting up of intrathecal pressure will awaken radikuler pain. This nerve pain according with the level of pathological process on canal of cervical vertebral. How to increase intrathecal pressure according to the Valsalva was the patient told topush when he held his breath. Results positive when there is radikuler pain that stem in the neck spread to arms.

Medical step in the recovery efforts from the cervical root syndrome, including:

A. Drugs.Anticonvulsant or muscle relaxants may be given to the acute phase during 7-10 days. If the situation of pain was felt so severe, necessary also narcotic analgesic such as codein groups, meperidin, even morphine could also be given. Ansiolitik can be given to patients who experience mental tension.

Drugs recommended in cervical root syndrome, such as :

• Ibuprofen 400 mg,tiap 4-6 jam ( PO )
• Naproksen 200-500 mg, every 12 hours ( PO)
• Fenoprofen 200mg, tiap 4-6 jam ( PO )
• Indometacin 25-50 mg, every 8 hours ( PO )
• Codeine 30-60 mg, every hour ( PO / Parentral )
• Vitamins of B1, B6, B12

B. Physiotherapy.

The main purpose of physiotherapy is the reduction and resolution of pain, improvement or resolution of deficit neurological and prevent complications or the involvement of further spinal cord.

Physiotherapy actions recommended are :

1. Traction

This action can be done continuously or intermiten if with only rest so that complaint of pain undiminished, or in patients with severe symptoms, and reflects the compression of radiks nerve.

2. Cervical Collar

The use of cervical collar purpose for cervical immobilization process and reduce the compression on the radiks nerve. One type of collar that is widely used SOMI Brace ( sternal occipital mandibular immobilizer ). Collar is used during 1 week of continuous day and night and changed by intermiten in the week II or if driving a vehicle, it is to overcome the pain on cervical pain ofnon-specific. If accompanied by irritation of radiks nerve, sometimes it mayneed 2-3 months. The loss of pain, loss of spurling sign, and improvement ofmotor deficits can be an indication the release of collar.

3. Thermotherapy

Thermotherapy used to eliminate pain. This modality treatment can be used before or at the time traction of cervical for muscle relaxation. Cold compresses can be given as much as 1- 4 times a day during 15-30 minutes. Heatcompresses or heating can be given as much as 2-3 times a day during 30 minutes, if with a cold compress if not achieved results.

4. Exercise

Exercises of neck mobilization towards anterior , exercises of shoulder slifting or exercises of strengthen muscles a lot of helping the recovery process of pain. Avoid movement extension. Reduction of pain may be caused by muscle spasm can be overcome by doing massage.

C. Sugery

Surgery action aimed more on the circumstances that caused by compression of radiks nerve or spinal cord disease that develops slowly and involve the legsand arms.

The step of treatment and prevention from pains of neck that can increase risk occuring cervical root syndrome are :

• Good posture where the body erected, chest lifted, shouldersrelaxed, chin in, neck felt strong, loose and relaxed.
• Sleep with a pillow or cushion Urethane.
• Maintaining joints muscles that flexible and strong with the proper training.
• Prevention of occuring cervical pain that repeated with consider sitting position, driving a vehicle, and neck positions related to various work or daily activities.
• Do not stay in one position too long.
• Avoid a circular motion of head that repeated when feelstired.

Posted in: cervical,health,syndrome