Cervical Radiculopathy involves an irritation of a nerve root in the neck, via either compression or inflammation in the region.
This can cause signs and symptoms including:
- Unilateral (one side) neck pain with sharp/burning pain radiating down the arm
- Numbness or pins and needles in the neck, shoulder and/or arm
- Symptoms are aggravated with particular neck movements eg turning your head over your right shoulder, looking upwards etc
- A deficit in reflexes, sensation and/or muscle power in your arm, shoulder or hand
The two main mechanisms of nerve root impingement or irritation include:
- Spondylosis leading to stenosis or bony growth in the cervical joints (common in older patients)
- Disc herniation leading to compression/inflammation of the nerve root (more common in younger patients)
This injury often comes on gradually, rather than due to a traumatic incident. Some contributing factors include:
- Restricted cervical (neck) range of motion
- Restricted thoracic spine range of motion
- Reduced muscle strength and control through the neck, shoulder and back
Assessment
Your physio will complete a thorough assessment to identify your diagnosis, and potential problems causing the issue. Their assessment may include looking at:
- Cervical spine (neck) range of motion
- Thoracic spine (mid-back) range of motion
- Neurological testing of your sensation, reflexes, and muscle power
- Grip strength
- Neurodynamic testing
- Manual hands-on assessment and palpation
Management
Your physiotherapist can use a variety of treatments to manage this issue. This may include hands-on techniques, such as joint mobilisation and soft tissue massage to reduce your symptoms and manage pain.
Exercise prescription is also part of management to improve deficits in cervical spine range of motion, thoracic spine range, scapula control and global neck & shoulder strength. Alongside this, addressing other factors such as ergonomics, sleeping positions and posture may also be included to prevent the issue reoccurring once your symptoms have settled.
Your physiotherapist may also discuss with you the use of pain management strategies including the use of anti-inflammatories or other medication which can be prescribed by your GP.
Referral on to a specialist may be an option recommended to you depending on the severity of your signs and symptoms. Your physiotherapist can guide on you on these options and refer on as needed.
