What is it?

Cervical radiculopathy, commonly called a "pinched nerve," occurs when a nerve in the neck is compressed or irritated where it branches away from the spinal cord. This may cause pain that radiates into the shoulder and/or arm, as well as muscle weakness and numbness.

Cervical radiculopathy is often caused by "wear and tear" changes that occur in the spine as we age, such as arthritis. In younger people, it is most often caused by a sudden injury that results in a herniated disk. In some cases, however, there is no traumatic episode associated with the onset of symptoms.

In most cases, the pain of cervical radiculopathy starts at the neck and travels down the arm in the area served by the damaged nerve. This pain is usually described as burning or sharp. Certain neck movements—like extending or straining the neck or turning the head—may increase the pain. 

Other symptoms include:

• Tingling or the feeling of "pins and needles" in the fingers or hand

• Weakness in the muscles of the arm, shoulder, or hand

• Loss of sensation

Some patients report that pain decreases when they place their hands on top of their head. This movement may temporarily relieve pressure on the nerve root.

Mechanism of Injury

Cervical radiculopathy most often arises from degenerative changes that occur in the spine as we age or from an injury that causes a herniated, or bulging, intervertebral disk.

Degenerative changes. As the disks in the spine age, they lose height and begin to bulge. They also lose water content, begin to dry out, and become stiffer. This problem causes settling, or collapse, of the disk spaces and loss of disk space height.

As the disks lose height, the vertebrae move closer together. The body responds to the collapsed disk by forming more bone—called bone spurs—around the disk to strengthen it. These bone spurs contribute to the stiffening of the spine. They may also narrow the foramen—the small openings on each side of the spinal column where the nerve roots exit—and pinch the nerve root.

Degenerative changes in the disks are often called arthritis or spondylosis. These changes are normal and they occur in everyone. In fact, nearly half of all people middle-aged and older have worn disks and pinched nerves that do not cause painful symptoms. It is not known why some patients develop symptoms and others do not.

Herniated disk. A disk herniates when its jelly-like centre (nucleus) pushes against its outer ring (annulus). If the disk is very worn or injured, the nucleus may squeeze all the way through. When the herniated disk bulges out toward the spinal canal, it puts pressure on the sensitive nerve root, causing pain and weakness in the area the nerve supplies.

A herniated disk often occurs with lifting, pulling, bending, or twisting movements.

Common Management Techniques

Physiotherapy uses a combination of massage, joint mobilisations, stretches and strengthening exercises 

You can do the following things at home:

• Heat and massage. Applying a heat pack to the painful area may help. Massage using an analgesic balm (ie. Voltaren, Fisiocrem) can also relieve symptoms. 

• Sleeping and pillows. Avoid sleeping on too many pillows. Pillows should support the head without bending the neck to an angle. 

• Tailored Exercise. Keep neck mobile within your comfort zone. We can design gentle exercise that aids a more rapid recovery. 

• Posture. Keep a good posture during all tasks. As part of a patient’s treatment, our Physiotherapist’s will demonstrate how to achieve this. 

• Pain Relief. Medications prescribed by your GP, such as pain relief of anti-inflammatories can assist in reducing pain.

Prognosis

Often Cervical Disc Pain is a transient and self-limiting condition that can recover in a matter of a few weeks. 

The Physiotherapists at Palms Physiotherapy are skilled in treating neck ailments and can effectively assist with pain relief and rapid recovery.