What is Cervical radiculopathy?
Cervical radiculopathy is a condition where a nerve is irritated or compressed as it passes through the tunnel between 2 vertebrae in its path to the arm.
What causes cervical radiculopathy?
The nerve is often irritated by inflammation from neighbouring joints or discs in the neck. The size of the tunnel may be reduced from factors such as raging, boney outgrowth or disc protrusion. The more the tunnel size is reduced the more likely the nerve is to be irritated.
Signs and symptoms of cervical radiculopathy
The most notable symptom is the severe ‘nerve pain’ in the arm. It is often a shooting, or burning type pain that is difficult to obtain relief from. Other symptoms can include pins and needles or numbness in the arm or hand. Muscle in the arm may also become weak. Sleeping can often be uncomfortable and difficult with a true radiculopathy.
Conservative treatment of cervical radiculopathy
Acute phase
In the acute stage (first 1–6 weeks), the treatment is aimed at reducing pain and increasing function. Anti-Inflammatories may be prescribed by you GP in the initial stages, particularly if sleep is affected. Manual therapy methods that have proven helpful to help ease the pain. Individualised education is provided on best sleeping and working positions and how to care for the neck.
Subacute phase
Once the severe pain has reduced, your physiotherapist will progress treatment to include manual therapy to gently mobilise both the joints and nerves of the neck to further decrease residual pain. Gentle exercises are added to ensure that the nerves can move normally with day-to-day movement of the arms, and to ensure return of good control of your neck by the neck muscles. Exercises are progressed when pain has reached minimal levels to ensure return of normal muscle strength of your neck and shoulder girdle. Advice and education are provided on self-care methods for your neck to prevent recurrent episodes.
Persistent phase
Some people have intermittent but lesser pain in the arm that persists for several weeks or even months. In these cases, physiotherapy methods, such as manual therapy for the joints of the neck and nerve structures can be helpful in addition to education about pain, self-care methods and lifestyle features. A comprehensive exercise program is an important aspect of management.
Usually physiotherapy is the first treatment approach, but if severe pain is not easing and the muscles are becoming weaker, neck surgery may be considered. Studies that have investigated those who do and do not have surgery show that there is no difference in the final result some two years later.
