By Sydney CBD Osteopath Dr Abbey Davidson
The nerves which supply the shoulders, arms and hands originate from the neck. Where nerves exit the neck bones or vertebra they are called nerve roots, and are labelled C1 through to C8. These nerve roots can become irritated or compressed, which can result in cervical radiculopathy, otherwise known as “pinched nerve”.
Cervical radiculopathy is defined by pain, weakness and/or loss of sensation in the distribution of the effected nerve root; located not only in the neck but in the shoulder, arm and hand too. Ruptured discs, degenerative changes, arthritis or injury to the neck can cause the pressure or pinching of the the nerve root. Those older than 40 years of age and females are more likely to suffer from cervical radiculopathy.
To reduce symptoms, we want to discourage any pressure on the effected nerves, and so, bringing down inflammation in the neck region is important. Applying ice indirectly (with a towel between your skin and the ice) for a recommended 20 minutes an hour, or application of an anti-inflammatory gel may be useful. Please remember that although your symptoms may present in the shoulder, arm or hand; therapeutic relief should be targeted at the neck region and source of symptoms. If these methods are not enough to bring down inflammation, your health professional or pharmacist may be able to recommend some anti-inflammatories medications or pain relief to help with your symptoms.
You should also assess your sleeping position, with the help of a health professional if required. How old is you pillow and is the the correct height for your head/neck? Your neck should be in a neutral position when you sleep, and you should try and avoid any position away from neutral, as extra pressure can be placed on exiting nerves.
Stretches and gentle range of motion exercises targeting the neck/shoulder/arms/hands are also recommended. This can free any scar tissue or tension which may be effecting the path of the nerve as it travels from the neck and into the arm. Your health professional can provide you with further demonstration in a session.
For more information on cervical radiculopathy, watch the video below from Sydney CBD Osteopath Dr Abbey Davidson, or click here.
Fortunately, with cervical radiculopathy, 75-90% of sufferers have symptomatic improvement without surgery.
In an initial session a health professional will ask a broad range of questions to narrow down your likely diagnosis. Assessment of the neck, shoulder, arm and hand regions will be performed with provocative tests to aid in the provision of an accurate diagnosis. A neurological screen may also be performed. This will assess the involvement of the nerves which the neck and arm share with reflex, sensation and strength testing. In some instances, your health professional may send you for further imaging such as an X-ray or MRI.
Manual therapy techniques will aim to decompress the neck region, decrease tension and attempt to free the nerve path from the neck through to the arm. Sessions will be complimented with the addition of an at home exercise/stretching regime which will be prescribed specifically for your level.
In some cases of cervical radiculopathy, a cervical collar or corticosteroid injections may be prescribed.
For more information on conditions of the Neck, click on the following conditions: