Article by Alex Clarke
What is a Cervical Radiculopathy?
Despite the somewhat strange name, a radiculopathy can be quite painful. The condition is commonly referred to as a pinched nerve, with pain, weakness or numbness spreading down the arm.The term radiculopathy comes from radix = “root”, with the nerve root being the common site of nerve pinching.
What Causes a Cervical Radiculopathy?
A radiculopathy generally occurs with irritation of the nerve root as it exits the spinal column. This irritation can be due to a number of reasons including:
What are the Symptoms of a Cervical Radiculopathy?
Pain is the most common symptom, with the worst pain often being felt further away down the arm.
The picture here shows common pain referral patterns for compression of nerves at different levels of the cervical spine.
Compression of the nerve may also lead to impaired nerve function, meaning that you may have areas of reduced sensation in the arm, or reduced power in muscles supplied by the compressed nerve.
How is a Cervical Radiculopathy Diagnosed?
Your physiotherapist is skilled at determining which structures may be causing your neck and arm pain. There are certain questions that they may ask you to help narrow down the diagnosis and this helps to guide a hands-on assessment. Your physio will palpate the muscles and joints around your neck, as well as perform testing of the nerves. If further investigation is required an MRI is the best way to diagnose a cervical radiculopathy, however, a CT scan or X-ray can still help with diagnosis.
Cervical Radiculopathy Treatment
PHASE I - Pain Relief. Minimise Swelling & Injury Protection
Managing your pain. Pain is the main reason that you seek treatment for this condition, and is our priority for you.
Managing your inflammation. Inflammation it best eased via ice therapy and techniques or exercises that deload the inflammed structures.
Your physiotherapist will use an array of treatment tools to reduce your pain and inflammation. These include: ice, electrotherapy, acupuncture, soft tissue massage, joint mobility techniques and use of taping techniques or an arm sling to off-load the injured structures.
PHASE II - Restoring Normal ROM & Posture
As your pain and inflammation settles, your physiotherapist will turn their attention to restoring your normal joint range of motion (ROM), muscle length, neural tissue mobility and resting muscle tension.
Treatment may include joint mobilisation and alignment techniques, massage, muscle stretches and neurodynamic exercises, plus acupuncture, trigger point therapy or dry needling. Your physiotherapist is highly experienced in the techniques that will work best for you.
PHASE III - Restore Normal Muscle Control & Strength
Researchers have discovered the importance of your muscle recruitment patterns with a normal order of: deep, then intermediate and finally superficial muscle firing patterns in normal pain-free people. Your physiotherapist will assess your muscle recruitment pattern and prescribe the best exercises for you specific to your needs.
PhysioWorks has developed a rehabilitation programme to assist their patients to regain normal muscle control of the neck and shoulders. Please ask your physio for their advice.
PHASE IV - Restoring Full Function
During this stage of your rehabilitation is aimed at returning you to your desired activities. Everyone has different demands for their bodies that will determine what specific treatment goals you need to achieve. For some, it may simply be to walk around the block. Others may wish to do boxing classes or return to a labour-intensive work.
Your physiotherapist will tailor your rehabilitation to help you achieve your own functional goals.
PHASE V - Preventing a Recurrence
Injury and the pain associated does have a tendency to return. The main reason it is thought to recur is due to insufficient rehabilitation.
Your physiotherapist is an experienced at identifying underlying joint restrictions and poor muscle patterning, and can help you to work on these to prevent recurrence.
What Results Can You Expect?
Disc and nerve injuries can take a while to recover as the blood flow to these structures can be poor, meaning healing takes longer. Generally, an acute radiculopathy will feel much better in one to two weeks, with resolution by three months. Some cases will take longer, with slower improvements for up to six to twelve months.
Surgery is not a common path but can be an option, particularly for patients who have extreme pain and frank nerve symptoms such as complete loss of muscle power or sensation. You will be referred to your GP, who will refer you to see a specialist. Scans such as an MRI may be ordered at this stage.
Other Treatment Options
Specific Interventions eg Injection
A cortisone injection or nerve block may be considered if other treatment fails. You will need a referral from your GP or specialist for this.
Many patients find that soft tissue massage therapy is beneficial in the early stages of their rehabilitation to assist your pain relief, muscle relaxation and swelling reduction. Please ask your physiotherapist if you would benefit from a massage.
Acupuncture can be helpful to relieve your pain. If you are interested in trying some acupuncture, many of our therapists are trained in acupuncture. Please ask for their advice.
Carrying excessive body weight can predispose you to injury or pain.
General exercises are important to keeping your body fit. If you have a specific activity that you enjoy, please ask your physiotherapist if that activity will be beneficial to your long-term health.
For this particular injury, other patients have benefited from the following activities: hydrotherapy, pilates, yoga, walking, swimming or cycling.
Some liniments and creams, such as Fisiocrem or Flexall, can provide pain relief by rubbing the cream into the neck, shoulder or arm. For more information please consult your physiotherapist or doctor.
Cervical Radiculopathy Treatment Options
Cervical Radiculopathy Related Products
Cervical Radiculopathy FAQs
Cervical Radiculopathy Related Conditions
Neck Joint Injuries
Nerve-related / Referred Pain
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