Investigation of C₅-C₆ radiculopathy and shoulder rotator cuff lesions coexistence frequency

The aim of this study was to evaluate the coexistence of C₅ and/or C₆ root compression with rotator cuff pathologies and its effect on pain and disability.

A total of 65 patients with pain radiating from neck to shoulder were retrospectively evaluated on the basis of demographic data, duration of symptoms, overhead activities, and physical examination. The visual numerical scale (VNS), Quick DASH (Disabilities of the Arm, Shoulder, and Hand), and Shoulder Pain and Disability Index (SPADI) were also used. Cervical magnetic resonance imaging (MRI) was used to evaluate C₅-C₆ root compression, which was separated into two groups as patients with or without upper trunk root compression (UTRC). These groups were compared according to the MRI findings of patients with rotator cuff pathologies.

According to our results, C₅ root compression (12.3%), C₆ root compression (41.5%), UTRC (44.6%) were detected. There was no difference between the groups regarding the Hawkins and Neer tests. The Yergason and Jobe tests were statistically higher in patients without UTRC. In the shoulder MRIs, the rate of subscapular muscle tear was significantly higher in patients with UTRC. Other shoulder MRI findings were not different between the groups. VNS-neck and SPADI-pain scores were significantly higher in patients without UTRC. There was no difference between the groups in the scores of VNS-shoulder, Quick DASH, SPADI-disability, and SPADI-total.

Radiating pain from neck to shoulder that is caused by C₅-C₆ root compression does not create a predisposition for clinical, radiologic, and functional pathologies in shoulder joint. It seems difficult to diagnose the exact origin of pain in patients who present with neck pain radiating to shoulder based on the findings of cervical or shoulder MRI alone.