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Cervical Radiculopathy Physiotherapy
Cervical radiculopathy is often referred to as a pinched nerve in the
It is primarily characterized by radiating pain from the neck to the
- shoulder blade
- arm or
Weakness and lack of
coordination in the arm and hand can also occur.
The condition affects
an average of 85 out of 100,000 people—most often in patients who are 50 years old and above. Individuals who are more at risk are:
- Athletes, heavy laborers, and workers who use vibrating machinery
- People who sit for long periods of time
- Individuals with arthritis in the cervical (neck) region can also be
Our senior physiotherapists can help bring pain relief to the acute neck and
arm symptoms that result from the condition, as well as improve general
strength and function. Most cases of cervical radiculopathy are resolved
with spinal physiotherapy (including computerized decompressive spinal traction therapy) and do not require surgery.
What is Cervical Radiculopathy?
Cervical radiculopathy occurs when a nerve root coming off the spinal
cord becomes compressed.
This compression can happy for many reasons.
- In younger people, it may occur when a cervical disc herniates due to
trauma such as in sports injuries, falls or accidents
- In older individuals, it commonly occurs spontaneously as a
result of arthritis or decreased disc height in the neck region (such as in degenerative disc disorder)
Our cervical (neck) spine is made of 7 cervical vertebrae (the bones that
form the neck region) and each spinal vertebra is separated by a gel-like disc.
What this spinal discs do is they provide shock absorption for the spine.
The spinal cord
travels through a canal in the cervical vertebrae and spinal nerve roots
extend from the spinal cord and branch off going to specific locations
in the arm.
The spinal nerves send signals to our muscles for movement
as well as sensations that we feel in the entire arm. The spinal cord is
like a tree trunk, and the spinal nerves are like the tree branches.
an impingement or abnormal pressure is placed on a branch near the
trunk, everything along that branch will be affected.
Our spinal nerves can be impinged by:
When the spinal nerves are impinged, they cannot properly send or transmit messages to the muscles from the brain, nor receive proper sensation
from the specific arm location the nerve travels.
Everywhere the spinal
nerve travels will be affected.
And that's why a compressed or pinched nerve in the neck
- and altered or loss of sensation in the arm
the pinch is in the cervical region.
How Does cervical radiculopathy Feel like?
Symptoms of cervical radiculopathy is different and varies depending on the nerve root
of the cervical that is involved/compressed, and usually it happens on the same side of the body as the
Cervical radiculopathy symptoms may include:
- Neck pain, shoulder blade pain, shoulder pain, upper chest pain, arm pain, with pain possibly radiating into the fingers following the path of the
involved nerve root.
- Pain described as "sharp" or "pins-and-needles" or “popping sensation” in cervical region.
- General dull ache or numbness anywhere along the pathway of the nerve.
- Weakness in the shoulder, arm, or hand.
- Pain that worsens with certain neck movements.
- Pain that improves when the arm is lifted over and behind the head (relieving tension on the spinal nerve).
These symptoms may also be specific to the nerve root involved:
- C5 nerve root (between cervical vertebrae C4-C5):
weakness in the deltoid muscle (front and side of the shoulder) and
upper arm; shoulder pain and numbness
- C6 nerve root (between cervical vertebrae C5-C6):
weakness in the bicep muscle (front of the upper arm) and wrist muscles;
numbness on the thumb side of the hand
- C7 nerve root (between cervical vertebrae C6-C7):
weakness in the triceps muscle (the back of the upper arm and wrist);
numbness and tingling in the back of the arm and the middle finger of
the affected hand
- C8 nerve root (between vertebrae C7-T1): weakness with hand grip; numbness in the little finger
The most common nerve root levels for this condition are C6 and C7.
How Is cervical radiculopathy Diagnosed?
When you seek the help of our senior physiotherapist,they will perform an in-depth comprehensive evaluation and asks questions about
your pain and your daily activities.
These may include:
- How and when the pain started: Did the pain begin spontaneously or
was there any trauma or popping experienced in the cervical region?
- Where are the symptoms located, and have they changed location or intensity since the onset?
- What makes the symptoms better or worse?
- What type of work do you perform?
- What hobbies or household activities do you regularly perform?
They will gently test the movement of your neck
and arms as well as check your tendon reflexes and strength,
and conduct special tests on your neck and upper extremity to determine
which spinal nerve root(s) may be involved, and to rule out other
To provide a definitive diagnosis, our senior physiotherapist may
collaborate with our medical network of doctors who may order further tests, such as
- magnetic resonance imaging
- electromyography (EMG)
An MRI can show soft tissues, including
the spinal cord and nerve roots. This test can determine what is
causing the compression on the nerves, including disc bulges or any spinal disc
herniation. An EMG measures the nerve and muscle function. This test can
tell how well your spinal nerves are communicating to your muscles.
How Can our senior PhysioTherapists Help?
Physiotherapy is an effective treatment for cervical
radiculopathy, and in many cases, it completely resolves your pains and
symptoms. We will develop an individual treatment plan based on
the findings of your initial evaluation.
Cervical radiculopathy physiotherapy treatment plan may include:
Pain Management. The first goal is to reduce the
pain and inflammation in the area. Cold therapy applied to the neck and
scapular (shoulder blade) region during the first 24 to 48 hours
following the onset of pain to help reduce inflammation. Moist heat can be
used after this time period to help the surrounding muscles relax. We may advise you to wear a soft cervical collar at
times throughout the day, to allow the neck to relax. A cervical
contoured pillow may be recommended to properly support the neck, and
allow you to sleep more comfortably.
Manual Therapy. We may use
manual therapy techniques, such as manual cervical traction (or computerized decompression spinal traction), to relieve
pressure in the cervical (neck) region. This procedure can provide
immediate relief of pain and numbness radiating into the arm. Gentle
massage may also be performed on the muscles of the cervical spine and
scapular (shoulder blade) region. This technique helps the muscles relax
and improves circulation to the area, promoting healing and pain
Posture Education. Posture education is an important
part of rehabilitation. We may suggest ergonomic adjustments
to your workstation and work habits, to promote good posture to protect
your neck. In the early stages of recovery this may mean sitting only
15 to 20 minutes at a time. You will also receive instructions on how to
bend, reach, and lift throughout the day in safe positions that place
minimal pressure on your spinal discs.
Range-of-Motion Exercises. We will teach you gentle cervical mobility exercises to relieve your
symptoms, and allow you to return to normal movement. In the beginning
stages of recovery, it is important that none of these exercises
increase the pain radiating down into your arm. It is important to
communicate your symptoms accurately to our senior physiotherapists. If you
spend many hours sitting at a desk during your workday, your neck may
become stiff. We will teach you neck stretches to take
pressure off of your neck from extended periods of sitting, to help
improve your mobility.
Strengthening Exercises. We
will help you determine which muscle groups need to be strengthened
based on which spinal nerves are involved in your particular case. When
pain no longer radiates down your arm, you may begin more aggressive
strengthening exercises. Neck stability (strengthening) exercises will
also be performed.
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Phoenix Rehab Group works with specialist physiotherapists and rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.
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See all the conditions our principal physiotherapists treat.
HAND THERAPY & CUSTOMIZED SPLINTING
Patients who sustained injuries to their elbows, forearms, hands, wrists
(sprains and fractures) and fingers, usually will benefit / require Hand Therapy to
- manage and decrease hand pains
- improve range of motion, strength and dexterity
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following injuries or post-operations
Commonly treated hand pain injuries includes
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It is a system of safe and effective exercises, which
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Sports and deep tissue release massage helps to increase nutrient-rich blood
flow to tired, tight and tense muscles to accelerate recovery and shorten downtime / recovery period required.
It also prevents
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performance. Having regular deep tissue and sports massage will keep your muscles healthy and fit with body/movement-confidence.
Read the benefits of regular deep tissue release therapy here.
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At the first session, our specialist physiotherapists will carry out a thorough
assessment, helping them to select the most appropriate treatment to
help you recover as well as provide treatment in the same session.
Follow up sessions are inline to provide
expert treatment for your pain as well as prescribing specific
exercises to reduce your risk of re-injury and giving you a long term
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