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What is a "pinched nerve"?

A "pinched nerve" in the neck can cause radiating pain into the shoulder, down the arm and into the hand.  The technical term for this is called "cervical radiculopathy" and is a common neurological disorder of the neck that results from problems with exiting nerve roots. Nerve roots are commonly altered by mechanical compression or chemical irritation (e.g. inflammation). Cervical radiculopathy often presents itself as neck, shoulder and arm pain, and may include symptoms such as numbness, pins and needles, weakness, and altered sensation in the neck and upper extremity1,2. Certain movements of the neck can increase or decrease the symptoms in the arm.

Cervical radiculopathy affects people of all ages, with men affected slightly more than women. The onset can be both gradual or sudden and often occurs with no specific trauma or physical exertion1,2.

 

What causes Cervical Radiculopathy?

Cervical radiculopathy is caused by anything that impacts nerve roots exiting from the spine. This includes, but is not limited to factors such as spondylosis (degeneration of the spinal segment) and compression from tight musculature in the neck which narrows the opening where the nerve passes through, pinching exiting nerve roots. Herniated discs and inflammation can also impact exiting nerve roots1,2.

 

What can physiotherapy do for cervical radiculopathy?

Physiotherapy can help individuals with cervical radiculopathy to manage their symptoms and increase range of motion of the neck and arm by decreasing the compression at the spinal level as well as along the course of the nerve, improve mobility of the nerve, reduce pain and inflammation and correct the underlying factors that lead to the onset of the radiculopathy.  Techniques used to achieve these goals include but are not limited to:

 

Therapeutic exercise (strengthening, stretching and range of motion) 1,3,4,5
Postural education and exercise 3
Functional exercise 3,5
Manual therapy 1,3,4  (mobilization, manipulation and soft tissue release)
Massage therapy 2,3,4
Inferential current 2,3
Heat applications 2,3
Acupuncture and Intramuscular Stimulation (IMS)

 

A comprehensive assessment is essential in determining the cause of the radiculopathy and to determine the best course of treatment for each individual.  Please contact us for more information on what physiotherapy can do for your neck and arm pain!

 

 

 

Henry Chan, UWO PT Student

 

References:

Woods, Barrett I. and Alan S. Hilibrand. "Cervical Radiculopathy". Journal of Spinal Disorders & Techniques 28.5 (2015): E251-E259. Web.

Eubanks, Jason David. "Cervical Radiculopathy: Nonoperative Management Of Neck Pain And Radicular Symptoms". Am Fam Physician 81.1 (2010): 33-40. Web.

Hoving, Jan Lucas. "Manual Therapy, Physical Therapy, Or Continued Care By A General Practitioner For Patients With Neck Pain". Annals of Internal Medicine 136.10 (2002): 713. Web.

Boyles, Robert et al. "Effectiveness Of Manual Physical Therapy In The Treatment Of Cervical Radiculopathy: A Systematic Review". Journal of Manual & Manipulative Therapy 19.3 (2011): 135-142. Web.

Cheng, Chih-Hsiu et al. "Exercise Training For Non-Operative And Post-Operative Patient With Cervical Radiculopathy: A Literature Review". J Phys Ther Sci 27.9 (2015): 3011-3018. Web.

 

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