Cervical Radiculopathy
Cervical Radiculopathy is also commonly known as pinched nerve. It occurs due to compression of spinal nerves or nerve roots which are located in your neck (cervical) region. Males are affected more commonly than females with higher incidence during their fifth decade.[1]
Age related wear and tear of the spine known as cervical spondylosis and disc herniation (bulging out of disc material) are two most common causes of cervical radiculopathy. However, at a younger age direct injuries to the spine resulting from MVAs, Contact Sports, Work Injuries etc. could also be a remarkable cause to a pinched nerve. If you have adopted poor posture, sedentary lifestyle or you have spinal abnormalities such as scoliosis then you are at higher risk for development of cervical radiculopathy. Occupations requiring prolong computer screen time also poses risk to developing cervical radiculopathy.
Common symptoms you might experience
- Constant neck and arm pain
- Tingling (pins and needle sensation) and numbness in arm
- Headache
- Inability to lift any objects due to weakness of muscles
- Tightness or spasm in Trapezius and Levator Scapulae muscles
Physical Therapy Interventions:
When it comes to accurate management of cervical radiculopathy, it becomes mandatory for us to conduct detailed assessment which not only includes analysis of your posture, neck mobility and strength of muscles but list of activities that exacerbate and relieves your symptoms as well. Then after, we follow scientific evidence-based approach:
Continuous neck pain which hampers your activities of daily living should be reduced first and thus we promote use of Interferential Current (IFC) which helps in reducing muscle spasm and thereby it decreases pain as well. Besides, hot packs serve the same purpose by increasing the delivery of nutrients and oxygen to the muscle. Stabilization Exercises which mainly creates isometric activation of Rectus Capitis Anterior, Rectus Capitis Lateralis, Longus Colli and Longus Capitis muscles provides greater stabilization to your spine.[2]
Progressive strengthening exercises known as isotonic or resisted exercise of cervical muscles along with scapular muscles such as Serratus Anterior, both middle and lower Trapezius, Rhomboids muscle are eventually added to your treatment plan. McKenzie Technique involves directional upper and lower cervical spine guided movements, it is generally very effective in decompressing the pinching nerve, correcting the cervical spine alignment and underlying muscle imbalances .[3] Selective stretching of Pectoralis, Upper Trapezius, Sternocleidomastoid and Levator Scapulae helps in correcting forward head posture which occurs as a result of cervical radiculopathy.[4] Maitland Thoracic Spine Manipulation helps in mitigating neck pain as well as improves mobility of your neck.[5] Neural Mobilization helps in maintaining elasticity and normal mobility of neural structures as well as it also improves muscles strength.[6]
The right treatment approach will address the musculoskeletal impairments at cervical spine, thoracic spine, shoulder blades and shoulder joints with corrective exercises and manual therapy.
If you are suffering from cervical radiculopathy, then these tips might be helpful:
- Adjust height of your reading table at eye level
- Avoid holding neck in one position for a longer period
- Use pillow of adequate height that supports your head and neck and should be extending up to your shoulder level
References:
1) Kang, K. C., Lee, H. S., & Lee, J. H. (2020). Cervical radiculopathy focus on characteristics and differential diagnosis. Asian spine journal, 14(6), 921
2) Akkan, H., & Gelecek, N. (2018). The effect of stabilization exercise training on pain and functional status in patients with cervical radiculopathy. Journal of back and musculoskeletal rehabilitation, 31(2), 247-252.
3) Kumar, S., Kumar, N., PraveShen, S., Kumar, R., & Sharma, N. (2021). Compare the effectiveness of McKenzie Techniques and Isometric Strengthening Exercise In Patients with Cervical Radiculopathy. European Journal of Molecular & Clinical Medicine, 7(11), 4679-91.
4) Wachidah, R. N., & Herawati, I. (2021). PHYSIOTHERAPY MANAGEMENT FOR CERVICAL RADICULOPATHY: A CASE STUDY. In Academic Physiotherapy Conference Proceeding
5) Aroob, A., Zahoor, I. A., Ghaffar, M., Ghaffar, N., Rana, A. A., & Shabbir, S. (2022). Comparison of the effectiveness of maitland manipulation of thoracic spine versus grade I and II Maitland mobilization of cervical spine on pain intensity and functional status in patients of cervical radiculopathy: cervical spine on pain intensity and functional status in patients of cervical radiculopathy. Pakistan BioMedical Journal, 134-138
6) ELSAYED, E., MOHAMMED, H., GHALLY, A., & YOUSSEF ELBALAWY, P. D. (2019). Effect of Neuro Dynamic Mobilization on Pain and Hand Grip Strength in Cervical Radiculopathy Patients. The Medical Journal of Cairo University, 87(December), 4207-4212.
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