Physiotherapy

Cervical Radiculopathy - When angry nerves in the neck give us neck pain, arm pain, and weak tingly fingers!

Post by
Brian Tran

Neck pain is one of the most common reasons people see our Physiotherapists and Chiropractors. Most of the time, this is from simple irritation of the muscles and joints, but when the nerves specifically become involved, this can often lead to neck pain that can spread down into their shoulders, middle back, arm, hands, and fingers. Some people even get pins and needles, numbness, and weakness in their hands, which are all typical features of Cervical Radiculopathy.

What is Cervical Radiculopathy?

Cervical radiculopathy is one of the more serious conditions of the neck which can lead to the people experiencing tingling, burning, numbness, and/or weakness in their arms. It happens when there is enough irritation to the nerves which come out the neck, that it starts to affect the messages being sent through those nerves down into the arm. As our nerves relay important information from our brain about sensation and movement, these start to become affected and can cause the nerve like sensations and weakness.  

bones of the neck showing the nerves
There are 7 bones in the neck with nerve roots that come out between the holes formed between the two bones.

The causes of Cervical Radiculopathy

The nerves in the neck can become irritated by things like trauma from motor vehicle accidents or contact sports, from sleeping on an odd angle and squashing the nerve, from over straining the neck, and sometimes even just a part of the naturally ageing process as we develop some rough edges in the bones around the nerves. As the condition progresses, patients may start to report episodes of weakness, clumsiness, and more frequently drop things when holding them.

Neck pain with radicular arm pain vs Cervical Radiculopathy

When the nerves of the neck are affected, this doesn’t always cause the nerves to lose signals into the arm. Sometimes the nerves just become slightly irritated, which can also cause pain, tingling, burning, and numbness but it is much less serious and easier to manage. The only way to tell is by performing a neurological examination of your reflexes, sensation, and strength which can check if nerves are working the right way, or with a nerve conduction study.

diagram of neck pain causing different patterns of arm shoulder and arm pain
The neck can often send pain down into the shoulder blade and ar

Testing for Cervical Radiculopathy

The best way to test for Cervical Radiculopathy is to have it assessed by a health professional. The best tests for this condition is to take a detailed history of how it came about, perform a physical examination on how the neck moves, and a neurological examination to see if there are any signs of nerve conduction loss, such as decreased reflexes, decreased sensation to sharp pain and light touch, and weakness in certain muscles groups. Sometimes scans of the neck can be useful too, such as with x-rays, CT scans, and MRI scans but these are not always necessary and should be avoided if possible. An MRI is the best type of imaging to fully assess the neck for cervical radiculopathy, and our practitioners at Dural Health can refer you for one if required.

Our approach to managing Cervical Radiculopathy

Once Cervical Radiculopathy is suspected or confirmed, our team of Physiotherapists and Chiropractors start by taking the time to explain what might be causing the nerve irritation, and organising any referrals for scans, specialists, injections, or medications that can help through your GP. To help in the recovery, we may use some hands on techniques such as massage, dry needling acupuncture, spinal mobilisations, and spinal manipulation to help control the symptoms and introduce some movement into the affected area. An exercise program is then put together to help carefully open up the bones in the neck around the nerves, to slide the nerves through the neck and arm, and to build up the strength in the muscles that are starting to get weaker. Over time, with more exercises and treatment, movements become less sensitive and the pain, tingling, burning, numbness, and weakness starts to resolve. From here, we make sure your arms and neck are as strong as they can be to stop it from happening again.

therapist giving treatment to the neck
Manual therapy, such as spinal mobilisations, can be useful in treating neck pain and Cervical Radiculopathy.

Cervical Radiculopathy and Surgery

Sometimes despite the best non-surgical treatment for Cervical Radiculopathy, the pain and symptoms get worse and the weakness does not resolve. In this case, it is highly recommended that a spinal surgeon review the case to see if surgery is required. This is always the last resort though, but the surgeon will want to know if everything has been trialled before surgery. We work closely with many spinal surgeons who we can recommend if the condition is not improving.

To learn more about this condition, speak to our Physiotherapists (Alex Fielding, Brian Tran, and Doris Qu) and Chiropractors (Nico Ebilane) who can comprehensively diagnose, assess, and manage cases of Cervical Radiculopathy. To make a booking, call us on 02 8403 4200 or make a booking online.

Dural Health. Reshaping Healthcare.

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