Herniation of a lower cervical disk is a common cause of neck, shoulder, arm, or hand pain or tingling. Neck pain (worse with movement), stiffness, and limited range of motion are common. With nerve root compression, pain may radiate into shoulder or arm. Extension and lateral rotation of the neck narrows the intervertebral foramen and may reproduce radicular symptoms (Spurling's sign). In young individuals, acute radiculopathy from a ruptured disk is often traumatic. Subacute radiculopathy is less likely to be related to a specific traumatic incident and may involve both disk disease and spondylosis. Clinical features of cervical nerve root lesions are summarized in Table 48-3.