Understanding Cervical Radiculopathy

Cervical radiculopathy

Duration: 6:41

Cervical radiculopathy is similar to a sciatica presentation. Like sciatica 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. This could 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. The cause of cervical radiculopathy most often stems from a reduction of space where the nerves branch out of your spine which could be from either degenerative changes or disc herniation. However, degenerative changes in the body are normal as we age and not all people with degenerative changes to the neck will have cervical radiculopathy. Ass 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 findings 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. 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 deformity, can all increase the chance. Some studies also reported that email and having a labor job regarding heavy lifting and operating vibrating machinery could also increase the risk of cervical radiculopathy. As we often know lots of people 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 the 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 effective in reducing neck pain. In terms of knowing whether you have cervical radiculopathy people usually feel stiffness with neck movements, decrease 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. 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 I have mentioned before, physiotherapists can recognize those signs and refer to additional imaging investigations. One very important thing to note is that cervical radiculopathy has favorable natural outcomes. As several studies suggest that symptoms typically reduce at six month mark without treatment. However, a tailor perform exercise plan in combination of physical therapy interventions can significantly reduce pain and improved function within four to six weeks and is a better alternative than wait and see. The physical therapy interventions you can expect to include education around symptom management and prognosis manual therapy, mechanical traction and making sure the home exercise plan is tailored to your specific presentation. Is surgery needed? Non surgical treatments such as physical therapy interventions and exercises are effective to improve symptoms and function with or without social intervention? Lots of researchers have concluded that modern surgical interventions may have more favorable outcome and short term, no differences between surgical and non surgical treatments were served. After one to two years however, there are cases where surgical interventions might be necessary, including what non surgical treatments fail when a person is showing profound acute neurological symptoms. And with dangerous traumatic injury has taken place interventions at home. People may want to try different things out home for pain relief, and some things like inversion table 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 increasing your general physical activity level. The general recommended dosage is at least three times a week for neck related exercises and at least three times a week of 30 minutes for general physical activity at a moderate intensity. Some examples of moderate intensity exercises including brisk walking like bicycling, social tennis or golf and general swimming for neck related exercises simply move head up and down. Right and tilting head set aside in a gentle fashion for two sets of 10 reps a couple of times a day can be helpful as well. While doing these exercises, you should feel some muscle activation around the neck, but this should not make your symptoms worse. Apart from physical exercises, practicing meditation for 10 minutes a day, maybe helpful. There are lots of resources on the internet such as headspace, and it's a timer that can get you started practicing calm breathing exercise are also helpful, simply Google breathing exercises on your web browser. And Google will show an app to take us through a simple one minute breathing routine to get you sorted and less than to do is try not to stress and worry as we know this will very likely get better. Remember, this is for informative purposes only and is not health device and does not replace the console with your care provider. If you have specific medical conditions and are experiencing pain, or you're just not too sure where to start when it comes to exercises, please remember we're here for you.

Presenter: Ms. Natasha Lohues, Physiotherapist, Vancouver, BC

Local Practitioners: Physiotherapist