Cervical radiculopathy, often called a “pinched nerve” in the neck, can cause debilitating arm pain, weakness, and numbness in the hands due to nerve root compression in the cervical vertebrae. The good news is that targeted rehabilitation, including physical therapy for cervical radiculopathy, can effectively alleviate symptoms and restore normal function. This blog will cover essential rehab strategies for cervical radiculopathy and how physical therapy at RecoverRx can help.
What is Cervical Radiculopathy?
Cervical radiculopathy is characterized by the irritation or compression of the spinal cord and nerves in the neck, often leading to pain, numbness, tingling, and weakness in the arms. This condition typically arises from various factors, including postural changes, degenerative changes in the spine, or disc herniation. Cervical radiculopathy physical therapy can help address these issues by reducing pain and improving function. As we age, our spines undergo natural degeneration, which can start as early as our 20s—the incidence of disc degeneration increases significantly by the time we reach our 60s. Less frequent than lumbar radiculopathies, cervical radiculopathies occur at an incidence rate of approximately 85 persons per 100,000.
Notably, around 30% of individuals by age 35 will exhibit signs of degeneration at one or more cervical levels, with over 90% showing some disc degeneration by age 60. While disc degeneration is less common in the cervical spine than the lumbar spine, it can still manifest, causing symptoms such as dull, throbbing radicular pain that may radiate to the shoulder and shoulder blade.
In particular, these symptoms can be exacerbated by poor posture or injuries such as whiplash, often leading to swelling that puts pressure on nerve roots. As a result, patients may experience shooting pain radiating into their shoulders, tingling sensations, and weakness in the upper limb muscles. If not addressed promptly, cervical radiculopathy can severely impact day-to-day activities and worsen over time. Fortunately, physical therapy can be a highly effective treatment option, helping to alleviate nerve pressure, restore spinal alignment, and enhance overall mobility, strength, and stability in the neck and upper body.
Common Causes of Cervical Radiculopathy
A variety of factors can lead to the development of cervical radiculopathy, such as age-related spine degeneration, degenerative disc disease, injury, manual labor, and poor posture.
- Herniated Discs: A herniated disc happens when the inner material of the disc protrudes, exerting pressure on nearby nerves. This condition can lead to radicular symptoms such as pain, tingling, and weakness in the affected areas.
- Degenerative Disc Disease: As we age, the spinal discs may deteriorate, resulting in nerve compression. This condition can lead to various symptoms, including pain and weakness in the neck and arms.
- Spinal Stenosis: Cervical radiculopathy occurs when the spinal canal narrows, compressing the nerves. This condition can result in pain, weakness, and numbness in the arms and hands.
- Injury: Traumatic events like whiplash from a car accident can cause dislocation of cervical spine structures. This displacement can result in nerve impingement and related symptoms.
- Poor Posture: Long-term poor posture, particularly with a forward head tilt, places additional stress on the nerves in the cervical region. This strain can exacerbate symptoms associated with cervical radiculopathy.
Symptoms of Cervical Radiculopathy
Cervical radiculopathy often presents various symptoms that affect the neck, shoulders, arms, and hands. Common symptoms include neck pain, sensory symptoms, radiating pain, numbness or tingling, muscle weakness, and loss of reflexes.
- Neck pain: The pain may vary from a persistent dull ache to intense, shooting sensations. This spectrum of discomfort can significantly impact daily activities and quality of life.
- Radiating pain: Radiating pain may extend from the shoulder to the arm, hand, or fingers. This can feel like a sharp or burning sensation that travels along the nerve pathways.
- Numbness or tingling: Individuals may experience sensations often described as “pins and needles” or numbness in the areas affected by cervical radiculopathy. These altered sensations can significantly interfere with daily activities and overall comfort.
- Muscle weakness: Muscle weakness may be experienced in the shoulder, arm, or hand. This weakness can impact the ability to perform everyday tasks effectively.
- Loss of reflexes: Diminished or absent reflexes may occur in the upper extremities. This can indicate a significant nerve function impairment and signal the need for clinical evaluation.
These symptoms often worsen with specific movements, such as turning the head or lifting objects, leading to acute neck pain.
The Role Of Physical Therapy
Physical therapy is an effective, non-invasive treatment for overcoming cervical radiculopathy. The primary goal of physical therapy is to relieve the compression on the nerves, reduce pain, improve mobility, and enhance overall function. Nonsurgical treatments are often recommended before more invasive options. At RecoverRx Performance Physical Therapy, our expert clinicians follow a cervical radiculopathy rehab protocol that includes manual therapy techniques to relieve nerve compression, reduce pain, and minimize inflammation.
Our therapists also understand that happy nerves require space, movement, and blood flow. They work to improve the mobility of the joints and soft tissue structures in your neck and teach you positions of relief that create more space around the irritated nerve. They also educate you on special exercises that help glide the nerves, making them less sensitive as they travel from the neck down to the hand. Finally, more global exercise should be incorporated to improve overall blood flow and provide fresh nutrients and oxygen to help the tissues heal.
While poor posture is rarely the only cause of cervical radiculopathy, Physical Therapy will also address proper spinal alignment and appropriate body mechanics that help reduce strain on the neck and spine. Further, by strengthening the muscles around the cervical spine, physical therapy will improve stability in the affected area, preventing chronic neck pain and reducing the risk of future injury or reoccurrence.
The Importance Of Early Intervention
Early intervention with physical therapy is crucial for patients with cervical radiculopathy, as systematic reviews show rapid improvement with early treatment. Ten of the 11 patients (91%) demonstrated a clinically meaningful improvement in pain and function following a mean of 7.1 (SD, 1.5) physical therapy visits and at the 6-month follow-up. By addressing the condition promptly, patients can prevent the progression of symptoms and avoid more invasive treatments, such as surgical interventions.
Exercises to Deal With Cervical Radiculopathy
Physical therapy exercises for cervical radiculopathy are essential for reducing pain and restoring function in individuals with cervical radiculopathy. Below are some effective exercises that target the cervical spine and help relieve nerve compression.
Chin Tuck
The chin tuck exercise enhances neck muscle strength while promoting better spinal alignment. It helps reduce tension at muscle insertion points, alleviating pressure on the nerves in the cervical region.
- How to perform: Sit or stand with good posture. Slowly tuck your chin towards your chest, creating a “double chin” effect while keeping your spine straight. Hold for 5 seconds and repeat ten times.
Traction Exercise
Cervical traction exercises gently stretch the spine, helping to create space between the vertebrae. This technique effectively alleviates pressure on the affected nerves.
- How to perform: Lie on your back with your neck supported by a rolled towel. Gently lengthen your neck by pushing your head away from your shoulders. Hold for 5-10 seconds and repeat five times.
Neural Flossing
Neural flossing is a technique that aids in the movement of nerves through their active range of motion to reduce compression and neuropathic pain. This mobilization can help relieve pain and improve function for individuals suffering from cervical radiculopathy.
- How to perform: Sit up straight and extend the affected arm to the side with the palm facing up. Slowly bend your neck away from the arm while lifting the arm slightly. Hold for 2-3 seconds and repeat ten times.
Neck Extensions
Performing neck extensions helps to enhance neck flexibility while alleviating stiffness. This exercise aids in the treatment of neck pain and promotes proper spinal cord injury prevention. It is essential for maintaining mobility and comfort in individuals affected by cervical radiculopathy.
- How to perform: Sit comfortably and slowly tilt your head backward, looking up at the ceiling. Hold for 5 seconds and return to the neutral position. Repeat ten times.
Side Tilts
This exercise stretches the muscles on the side of the neck, alleviating stiffness and discomfort caused by muscular pain, particularly in chest muscles affected by poor posture. It promotes better flexibility and relaxation in the affected area.
- How to perform: Gently tilt your head to one side, trying to touch your ear to your shoulder. Hold for 10 seconds and repeat on the other side. Perform five repetitions on each side.
Isometric Holds
Isometric exercises enhance strength without movement, contributing to neck stability and preventing disabling pain. This approach is particularly beneficial for individuals dealing with cervical radiculopathy.
- How to perform: Place your hand on your forehead and press your head against your hand without moving your neck. Hold for 5 seconds and repeat ten times.
Shoulder Circles
Shoulder circles enhance shoulder mobility and upper limb flexibility while helping to alleviate tension in the neck. This simple exercise promotes relaxation and can contribute to improved overall neck function.
- How to perform: Stand or sit with your arms relaxed at your sides. Gently roll your shoulders forward in a circular motion for ten repetitions, then backward for ten repetitions.
Side to Side Strengthener
This exercise targets the muscles on the sides of the neck to build strength and improve posture for a multimodal approach to recovery. Reinforcing these muscles can enhance stability and support for the cervical spine.
- How to perform: Sit in an upright position. Place your right hand on the right side of your head and press your head against your hand without moving your neck. Hold for 5 seconds and repeat on the left side. Perform ten repetitions per side.
Conclusion
Cervical radiculopathy can be painful and limiting, but mechanical traction and physical therapy offer a path to full recovery. Through pain relief, strengthening exercises, range of motion improvements, and patient education, physical therapy helps individuals relieve their symptoms and return to daily activities. If you or someone you know is suffering from cervical radiculopathy, consider reaching out to our team for expert care and guidance on creating a personalized treatment plan that includes non-invasive techniques such as manual therapy, cervical traction therapy, and therapeutic exercise.
FAQs
Does physical therapy work for cervical radiculopathy?
Yes, physical therapy is an effective treatment for cervical radiculopathy. A randomized study showed that 91% of patients reported significant improvement in pain and function after undergoing physical therapy, with an average of just over seven therapy sessions. Therapy focuses on relieving nerve compression, improving mobility, and strengthening the neck and surrounding muscles to prevent future issues.
What is the most effective treatment for cervical radiculopathy?
The most effective treatment often depends on the severity of the condition. Non-invasive treatments like physical therapy, which includes exercises, manual therapy techniques, and postural training, are commonly effective. In more severe cases, transforaminal steroid injections or surgery may be considered if conservative treatments fail.
What is the best exercise for cervical radiculopathy?
The chin tuck is one of the most recommended exercises for cervical radiculopathy. It helps realign the neck, reduce nerve bed compression, and improve posture, all essential for alleviating symptoms.
