478 - Undiagnosed Chronic Cervical Radiculopathy Identified on EMG a Case Report

Case Diagnosis: chronic multilevel cervical radiculopathy with active changes noted at the C5-C6 levels on the left

Case Description: 24 y/o male presenting with a history of left upper back pain, neck pain, left shoulder stiffness, and mild left arm weakness that began two years ago while deadlifting. While lifting 315 lbs he noticed sudden onset, constant dull pain in the left neck, upper back, and shoulder. Now reports constant pain and occasional left arm numbness and paresthesia occurring 1-2 times per week when working out, particularly with chest press. He denies any weakness, bowel, or bladder incontinence.
Physical examination with intact strength/sensation, and a negative Spurling's test.
EMG revealed fibrillations in the left brachioradialis and positive sharp waves in the left cervical paraspinals, indicating active and chronic denervation, respectively. These findings provide electrodiagnostic evidence of chronic multilevel cervical radiculopathy with active changes noted at the C5-C6 levels on the left.

Discussions: While lumbar radiculopathy can be associated with deadlifting, there is no specific case reports that directly attribute cervical radiculopathy to deadlifting. Approximately one-third of cervical radiculopathies are caused by trauma or physical activity (1). Deadlifting, when performed with improper technique or excessive weight, can place significant mechanical stress on the spine (2). The persistence of symptoms over two years, despite a benign physical exam, underscores the diagnostic challenges in such cases and highlights the importance of considering electrodiagnostic studies in patients with prolonged, activity-related cervical and upper extremity symptoms. The patient's vague intermittent numbness during specific workouts was suggestive of radiculopathy. The use of EMG in this case provided definitive evidence of radiculopathy. Further imaging evaluation was recommended to confirm the diagnosis and guide treatment.

Conclusions: This case presents a unique instance of chronic cervical radiculopathy in a young athlete and highlights the need for awareness of cervical spine injuries in weightlifting athletes.