Cervical radiculopathy simply means pain coming from your neck that causes referred pain down your shoulder blade, arm or hand. It is a condition that occurs when there is a problem around a nerve root in your neck.¹ The nerve is responsible for sending signals for movement to the different parts of your arm, as well as receiving sensory information from your arm. If a nerve root is dysfunctional, it can cause symptoms like pain, numbness or weakness in the arm. This is commonly seen in people over the age of forty.³

What causes cervical radiculopathy?

This condition is sometimes caused by a trauma like a strong pull on the nerve and then nerve becomes irritated. It can also be non-traumatic, where the space around the nerve becomes narrowed or occupied. With less space, the nerve can become compressed or irritated. There are a few structures around the nerve root that can cause this narrowing or occupation of space, for example:

  • A herniated disc pressing on the nerve
  • Osteoarthritis of the neck with bone spurs pressing into the nerve
  • Chemical irritation of the nerve due to inflammation in surrounding neck tissue.¹

What are the signs and symptoms?

  1. Neck pain.
  2. Shoulder blade pain.
  3. Loss of sensation in specific parts of the arm and hand (depending on the affected nerve root).
  4. Specific muscle weakness in the arm and hand (depending on the specific nerve root).
  5. Headaches.¹

How is cervical radiculopathy diagnosed?

Your physiotherapist will first do a physical check to understand the behaviour of your symptoms. He/she will then perform a physical exam. This will consist of an assessment of the neck and shoulders, tests for reflexes and sensation of the upper limb, as well as strength of the upper limb. They may also perform physical tests to assess the sensitivity of the nerves coming from your neck.²

If the physiotherapist thinks it is necessary, they may also refer you to a specialist who can order further diagnostic imaging, like X-rays and an MRI to see what could be compressing the nerve.

What treatment is involved?

Physiotherapy is effective in the management of most cervical radiculopathy cases². However, in some cases, the nerve root compression may be severe. If, after 6-12 weeks of physiotherapy, the symptoms are showing no signs of improving or you are deteriorating over time, you may need to consider other medical or surgical options.¹

Physiotherapy will consist of:

  • Mobilisation of the joints and soft tissue in the neck to improve range of motion.
  • Techniques to mobilise the nerves.
  • Postural correction.
  • Strengthening of the neck, upper back and shoulders.

Rehabilitation for cervical radiculopathy will be progressed slowly as the symptoms decrease. For reasonable progress, commitment to the exercise programme by the patient is vital.²

This article was submitted by Kirsty Mackay from the Fourways branch of Lamberti Physiotherapy. You can make an appointment with her if you feel your symptoms may be similar to those noted in this article. Simply complete an online appointment form.

References:

  1. Caridi, J; Pumberger, M; Hughes, A (2011) Cervical Radiculopathy: A Review; HSSJ 7: 265-272.
  2. Nee, R; Vicenzino, B; Jull, G; Cleland, J; Coppieters, M (2012) Neural Tissue Management Provides Immediate Clinically Relevant Benefits Without Harmful Effects. For Patients With Nerve Related Neck And Arm Pain: A Randomized Control Trial; Journal of Physiotherapy, 58:23-31.
  3. Sravisht, I; Han Jo, K (2016) Cervical Radiculopathy; Curr Rev Musculoskeletal Med, 9: 272-280.