Cervical radiculopathy · Neck surgery alternatives · St. Louis
Before anyone fuses
your neck
Most cervical radiculopathy, the pinched nerve that sends pain, tingling or weakness down one arm, can be treated without surgery. At Regen.MD in St. Louis we first confirm which level and which part is irritating the nerve. Then we treat it with your own biology: platelet-rich plasma, bone marrow concentrate or microfragmented fat. Each is placed under ultrasound and fluoroscopic (live X-ray) guidance. At the same time we fix the metabolic inflammation that keeps the nerve swollen.
Is it the disc, the joint, or the nerve?
An MRI shows every worn disc and bone spur in your neck. It does not show which one is causing your arm pain. And by middle age almost everyone has findings. The usual causes are a disc bulge pressing on the nerve root, or a narrowed nerve opening from an arthritic facet joint. Loose ligaments that let the segment shift are another. So is a nerve that is swollen inside its own sheath.
Each one is treated differently, so we test before we treat. That means a focused exam, a review of your imaging, and diagnostic blocks when the source is unclear. Pain that runs from the neck into the shoulder blade is often a neck-and-shoulder chain problem, not a single bad disc.
Why fusion is a one-way decision
A fusion removes the disc and joins the bones with hardware. It cannot be undone, and it moves the load to the levels above and below. Ten-year data puts the chance that a healthy level next door breaks down afterward at about one in four. That is the case we make in Neck Fusion Alternatives.
Surgery remains the right answer for some necks, and Dr. Padda says so plainly when it is.
What we place, and where
Platelet-rich plasma concentrates the repair signals already in your blood. Bone marrow concentrate and microfragmented fat (Lipogems) carry a denser load of cells and structure. They are for tissue that has lost more ground. The full evaluation decides which one to use and where to put it. The target may be the facet joint, the ligaments that hold the segment steady, or the space around the irritated nerve root.
Each injection is guided by ultrasound or fluoroscopy, because a shot aimed at the wrong spot fails no matter what is in the syringe. Why nerve blocks and epidurals stop working explains the difference between quieting a nerve and repairing what irritates it.
The terrain under the nerve
A nerve root sits in the same chemistry as the rest of you. Insulin resistance and the low-grade inflammation that comes with it keep nerve tissue swollen. They slow every repair process. That is why the nerve is often the victim, not the criminal. Poor sleep turns up pain signals. Eight hours a day at a screen loads the lower neck in the same position for years. We measure the first two and plan around the third.
When surgery comes first
Some symptoms are not radiculopathy. Clumsy hands, a change in your handwriting, an unsteady walk or new bladder trouble point to pressure on the spinal cord itself, and that goes to a spine surgeon first. So does weakness that is getting worse week by week.
Not sure this is your problem? Take the 60-second candidacy check: am I a candidate?. Related: PRP for degenerative disc disease and facet pain.
Questions patients ask
How long does a pinched nerve in the neck take to heal?
Many pinched nerves settle over weeks to a few months as the swelling around the root goes down. If arm pain lasts past that, or keeps coming back, something is still irritating the nerve. That is when finding the cause matters. Chronic neck and shoulder pain is not just aging covers why it lingers.
What can be mistaken for a pinched nerve in the neck?
Shoulder problems, carpal tunnel syndrome, thoracic outlet compression and trigger points in the neck muscles can all send pain into the arm. Having two at once is common. That is why treating one site alone fails. See the cervical-shoulder kinetic chain.
What happens if a pinched nerve in your neck goes untreated?
Most cases do not cause lasting damage, and many get better on their own. The exception is weakness that keeps getting worse, muscle wasting, or signs of pressure on the spinal cord. Those need a prompt checkup, because a nerve under steady pressure can lose function that does not fully come back.
Can PRP help a pinched nerve in the neck?
PRP treats the tissue around the nerve: the facet joint, the ligaments and the inflamed setting of the root. We use it where the full evaluation shows that tissue is the source. And we tell you when it is not.