1. Neck pain and neck stiffness are often the first symptoms to appear. Some patients also have pain in the shoulder and the medial edge of the scapula. 2. Radiating pain or numbness in the upper extremities. This pain and numbness radiates along the course and innervation area of the affected nerve root and is characteristic, hence the name root-type pain. The pain or numbness can be episodic or persistent. Sometimes there is a clear relationship between the appearance and relief of symptoms and the position and posture of the patient’s neck. Neck movement, coughing, sneezing, exertion and deep whistling can cause aggravation of symptoms. Ju Hongbin, Crest Surgery Department, Guangzhou First People’s Hospital 3. The affected upper limb feels heavy, has reduced grip strength, and sometimes appears to hold objects falling down. There may be symptoms of vasomotor nerve, such as swelling of the hand. Muscle atrophy may appear in the late stage. 4. Clinical examination: neck stiffness and restricted movement. Tension in the affected neck muscles, pressure pain in the spinous process, paraspinal process, medial edge of the scapula and muscles innervated by the affected nerve roots. The presence of pressure pain in the intervertebral foramina with radiating pain or numbness in the upper extremities, or aggravation of existing symptoms, has localizing significance. A positive intervertebral foramen crush test and a positive brachial plexus nerve pull test are indicated. A careful, comprehensive neurological examination is helpful in localizing the diagnosis.