Neck or scapular pain radiating down the arm is typically caused by nerve compression in the cervical spine. This may also lead to numbness or weakness. In some patients, spinal cord compression can cause issues with hand function, difficulty walking, and walking imbalance (ataxia). The main causes include:

• Cervical disc herniation, also known as a herniated disc
• Cervical spondylosis with radiculopathy
• Cervical spondylosis with myelopathy

A smaller percentage of cases may be due to:

• Ossified Posterior Longitudinal Ligament (OPLL)
• Cervical spine fractures
• Spinal infections
• Spinal tumors

Pain severity can range from mild to severe.

• In the case of nerve compression: Neck or scapular pain that radiates down the arm, extending to the upper arm, elbow, forearm, wrist, or even the hand. Numbness or weakness may also be present.
• In the case of spinal cord compression: Patients may experience abnormal hand function or hand clumsiness, difficulty walking, walking imbalance (ataxia), and numbness or weakness in the arms and legs. Spinal cord compression is an urgent condition requiring treatment.
• Some patients may experience both nerve and spinal cord compression simultaneously.

To determine the cause of nerve and spinal cord compression in the neck, a Magnetic Resonance Imaging (MRI) test is often performed. An MRI can reveal the pathology, location, and severity of the compression. It may be considered in conjunction with a plain X-ray.

Treatment depends on the cause and severity of the nerve compression. It generally consists of:

• Lifestyle modifications
• Medication
• Physical therapy
• Epidural steroid injections
• Surgery, when indicated