Classic history and presentation: Patients typically present with pain described as radiating from the shoulder and/or neck down to one or both arms and forearms. They may also report numbness and tingling in the arm(s). Most patients describe an insidious onset without a history of trauma or acute incident.
- Age – Peak incidence occurs around the age of 50 years.
- Sex / gender – Seen in about 107 per 100 000 men and 64 per 100 000 women.
- History of smoking
- Rheumatoid arthritis
- Vascular disease
- Past lumbar radiculopathy
- History of heavy lifting and activities like golf
- Up to 75% of cases occur as a result of foraminal narrowing secondary to decreased disk height and hypertrophy of joint surfaces. Disk herniation accounts for about 25% of CR cases and therefore plays a less significant role than the lumbar spine.
- Nerve root compression occurs at C7 most frequently.
- Spinal tumors and infections are known causes but are relatively infrequent.
- Disk breakdown increases load-bearing on intervertebral joints, which leads to bony hypertrophy. These osteophytes press on nerve root(s).
- The compression of the nerve root leads to a localized inflammatory response that is believed to explain the associated pain. The numbness and weakness are a result of nerve hypoxia. Chronic processes, like degeneration and spondylosis, allow the patient to gradually adapt and therefore have a more insidious onset of pain and sensorimotor symptoms.