Cervical Radiculopathy / Pinched Nerve

Do you have a pinched nerve (also known as Cervical Radiculopathy)? Here you will find what it is exactly, what are its risk factors and what you can do for treatment.

PLEASE NOTE: this is for informative purposes only and is not health advice and does not replace a consult with a health care provider. If you have specific medical conditions, are experiencing pain, or you’re just not sure where to start when it comes to exercise, please remember we’re here for you.

For more information, click on one of the topics below:

What is Cervical Radiculopathy?

Cervical Radiculopathy can involve a single nerve or several together; these nerves travel down to your shoulders, arms, hands, and fingertips, which lead to the presentation of pain in one or more of those areas, on one or both sides of the body. It can also lead to muscle weakness, and sensation changes such as pins and needles, and numbness.

cervical radiculopathy illustration

Cervical radiculopathy is similar to a sciatica presentation

sciatica nerve pain

Like sciatica, cervical radiculopathy is caused by irritation to the nerves in the spine. While sciatica happens in the leg because of irritation to the nerve from the lower back, cervical radiculopathy happens in the neck region.

What causes Cervical Radiculopathy?

The cause of cervical radiculopathy most often stems from a reduction of the space where the nerves branch out of your spine, which could be from either degenerative changes, or disk herniation. However, degenerative changes in the body are normal as we age, and not all people with degenerative changes in the neck will have cervical radiculopathy.

As for disc herniations, most disc herniations tend to get better with natural history, along with symptom improvement. There are also some rare causes including cancer, abscess, and vascular deformities in the cervical spine.

These things sound scary, but they are rare, and can be screened by a physiotherapist with some simple questions to see if any additional investigations are needed.

What are common risk factors for Cervical Radiculopathy?

This condition is more common after the age of 40, but there are lots of factors that can increase the risk. Some personal factors such as smoking, history of trauma to the neck, and cervical deformities at birth can all increase the chance. Some studies also reported that being male, and having a labor job requiring heavy lifting and operating vibrating machinery could also increase the risk of cervical radiculopathy.

As we often know, lots of people who have office jobs complain about neck pain as well, and may be interested in knowing whether posture and workplace ergonomics can reduce neck pain; What science suggests right now is that there is not a specific posture that is best for everyone, but having the upper body supported may be effect in reducing neck pain.

How do you know if you have Cervical Radiculopathy?

In terms of knowing whether you have cervical radiculopathy, people usually feel stiffness with neck movements, decreased neck range of motions, and having increased symptoms when they look up and to one or both sides.

However, it is best to consult a physical therapist when you suspect you have cervical radiculopathy, and we make recommendations based on your unique history and symptom presentation.

Do you need an x-ray to diagnose Cervical Radiculopathy?

Most of the time, imaging is not required to make a diagnosis, and is not recommended in the first few weeks. However, in the rare cases that the symptoms may be caused by more serious pathologies as mentioned above, physiotherapists can recognize those signs and refer to additional imaging investigations.

Do you think you have Cervical Radiculopathy?

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How long does it take Cervical Radiculopathy to heal?

One very important thing to know is that cervical radiculopathy has favorable natural outcomes, as several studies suggest that symptoms typically reduce at the 6 months mark, without treatment.

However, a tailored home exercise plan in a combination of physical therapy interventions can significantly reduce pain and improve function within 4-6 weeks and is a better alternative than “wait and see.”

When is surgery necessary for Cervical Radiculopathy?

Researchers have concluded that although surgical interventions may have more favourable outcomes in the short term, no differences between surgical and non-surgical treatments were observed after one to two years.

However, there are cases where surgical interventions might be necessary, including when non-surgical treatments fail, when a person is showing profound acute neurological symptoms, and when dangerous traumatic injury has taken place.

How does Physiotherapy help Cervical Radiculopathy?

The physical therapy interventions you can expect include: education around symptom management and prognosis, manual therapy, mechanical traction, and making sure the home exercise plan is tailored to your specific presentation.

Non-surgical treatments such as physical therapy interventions, and exercises are effective to improve symptoms and function with or without surgical intervention.

education on symptom management for cervical radiculopathy

Education around symptom management

manual therapy for cervical radiculopathy

Manual therapy

home exercise plan

Home exercise plan

At-Home Treatment for Cervical Radiculopathy

People may want to try different things at home for pain relief, and some things like inversion tables or a neck traction belt may come to mind. However, there is no clear evidence on the effectiveness of those interventions. What could be effective in pain reduction is a soft or semi-hard cervical collar. 

A large component of home intervention should be neck-related exercises, as well as general physical activity. The general recommended dosage is at least 3x/week for neck related exercises, and at least 3x/week of 30 minutes for general physical activity at a moderate-intensity.

For neck related exercises, simply moving your head up and down, left and right, and tilting your head side to side in a gentle fashion for 2 sets of 10 reps a couple times a day can be helpful. While doing these exercises, you should feel some muscle activation around the neck, but this should not make your symptoms worse. 

Some examples of moderate-intensity exercises include brisk walking, light bicycling, social tennis or golf, and gentle swimming. Apart from physical exercises, practicing meditation for 10 minutes a day may be helpful. There are lots of resources on the internet such as Headspace, and Insight Timer that can get you started. Practicing calm breathing exercises are also helpful. Simply google “breathing exercises” on your web browser, and Google will show an app to take you through a simple one minute breathing routine to get you started. And the last thing to do is try not to stress and worry, as we know this will very likely get better.

soft cervical collar

Soft Cervical Collar (Image from Health Mart)

If you think you may have Cervical Radiculopathy, seek out a physiotherapist. They can provide you with education around symptom management and prognosis, manual therapy and a home exercise plan that is tailored to your specific presentation.

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