An acute or chronic neuromusculoskeletal disorder caused by pressure on the nerves exiting the neck by degeneration changes of the joints in the neck, inflammation or bulging disc. This is classified as a Grade 3 neck problem (neck pain accompanied by radiculopathy).

Signs and Symptoms

Pain is often felt in the side of the neck, back of the head, shoulders and mid back. Arm and hand pain, tingling or numbness may occur. Often the pain is increased by leaning the head back or towards the side of complaint. Relief is often felt by placing the hand of the sore arm on the head.

Diagnosis

Diagnosis of a cervical radiculopathy is made primarily from the patient’s history, orthopaedic and a negative neurological exam. Neuroimaging is indicated in patients with a positive neurological exam or presence of a “red flag” (warning signs suggesting a more serious medical condition) [2]. Chiropractors are well trained to take a thorough history and perform a orthopaedic and neurological examination. If we detect any signs that your condition is more suitable for medical treatment we will recommend a referral to your GP, in severe cases, surgery might be considered.

Evidence based summary for manual therapy [53]

The Bone and Joint Decade 2000-2010 Task on Neck Pain and Its Associated Disorders [33,34] synthesised the latest best evidence for the treatment and management of both traumatic and non traumatic neck pain, including cervical radiculopathy.

Other effective non-invasive physical treatments or patient education

 

Back-in-Action clinical comment

The aim of treatment is to reduce inflammation, promote soft tissue healing, relieve pain, increase pain-free range of motion, decrease pressure on the nerve, prevent reoccurrence and restore strength and stability to the local area.

In our experience treating the symptoms and underlying causes that sustain the symptoms of cervical radiculopathy is usually more effective with a combination of treatment techniques. We find it is especially useful to manage postural problems placing pressure on the lower neck.

Our approach often incorporates spinal manipulation, mobilisation, muscle release techniques, acupuncture, neck exercises, referral for massage therapy, diet and nutritional advice, functional neurological exercises, cryotherapy (heat and/or ice), postural improvements, breathing techniques, ergonomic advice and relaxation counselling. Sometimes a cervical collar or cervical home traction techniques are also useful. Our approach recognises neck pain as being multi-factorial and recognises the uniqueness of each individual and the causes of their complaint.