Radiculopathy

Radiculopathy is the medical term for trouble with a nerve root, where a spinal nerve leaves the spine. When a nerve in the neck is pinched by a slipped disc or bone, doctors call it cervical radiculopathy (NHS). In the lower back, the best-known version is sciatica (NHS).

The symptoms follow the nerve rather than staying at the spine: a sharp or burning pain, pins and needles, numbness or weakness, felt down an arm or a leg (NHS).

What causes radiculopathy?

In the neck. A classic population study comes from Rochester, Minnesota, where researchers identified 561 people diagnosed between 1976 and 1990 (Radhakrishnan et al., 1994):

• The C7 root, low in the cervical spine, was the most often affected, followed by C6.
• A disc protrusion alone was responsible in 21.9%; 68.4% were linked to age-related wear (spondylosis), a disc problem or both. Bony overgrowth from the small uncovertebral joints at the sides of the vertebrae is one way wear can press on a nerve root (Hartman, 2014).
• Only 14.8% had a strain or injury beforehand. The condition was most common in people aged 50 to 54.

In the lower back. The NHS lists a slipped disc (herniated disc) as the most common cause of sciatica; other causes include narrowing of the spinal canal, a vertebra slipping out of position and back injuries (NHS).

Radiculopathy does not always start in the arm or leg

Definitions vary, and there is no agreed medical definition of cervical radiculopathy. A scoping review of 86 studies found pain was described in the neck in 88%, the arm in 85% and around the shoulder blade in 72%, and that shoulder blade pain may come weeks before arm pain (Carmichael et al., 2025). In 50 people who had surgery on a single compressed root in the neck, the neck or shoulder blade pain came first in 70% and eased soon after the operation in 92% (Tanaka et al., 2006). So pain between the shoulder blades can occasionally be a nerve root problem.

At a desk, tingling fingers can come from several places. The NHS lists a trapped nerve in the back or neck among the causes of long-lasting pins and needles (NHS), but a nerve can also be squeezed at the elbow (ulnar nerve) or the wrist (carpal tunnel syndrome). That is one reason a clinician may examine your neck as well as your arm when your fingers tingle.

What happens over time?

• Most people recover. In the Rochester study, 90% had no symptoms or only mild problems after a median of 4.9 years, though 31.7% had a recurrence and 26% had surgery (Radhakrishnan et al., 1994). The NHS says sciatica usually gets better in a few weeks to a few months (NHS).
• Early treatment in the neck. In a trial of 205 people with symptoms for less than a month, arm pain fell by about 19 points out of 100 over six weeks with a wait-and-see approach. A semi-hard collar with rest, or physiotherapy with home exercises, each gave about 12 points of extra relief (Kuijper et al., 2009). That collar was prescribed for a diagnosed radiculopathy; for ordinary neck pain the NHS advises against wearing one unless a doctor tells you to (NHS).
• Scans need to match symptoms. In 1,211 adults with no symptoms, 87.6% had bulging discs on a neck MRI, including most people in their 20s (Nakashima et al., 2015). For sciatica, NICE advises against routine imaging outside specialist settings, against gabapentinoids, oral steroids and benzodiazepines, and suggests considering surgery when other treatment has not helped and the scan fits the symptoms (NICE).

When to see a doctor

Ask for an urgent GP appointment or contact NHS 111 if you have pins and needles in an arm with neck or arm pain, heaviness or weakness in your arms or legs, or severe neck pain that starts suddenly. Call 999 if you have new problems walking, a sudden lack of co-ordination such as trouble buttoning a shirt, or loss of bladder or bowel control (NHS). For the lower back, go to A&E or call 999 if you have sciatica on both sides, severe or worsening weakness or numbness in both legs, numbness around your genitals or bottom, or problems controlling your bladder or bowels (NHS). The full list is in red flags.