Causes of cervical radiculopathy

The most likely cause of your neck pain or arm pain (cervical radiculopathy) is inflammation around the nerve causing a lack of oxygen and damage to the nerve sheaf cells. However, a true mechanical impingement of the nerve root due to a bone spur or cervical disc herniation, either from spinal wear and tear and degeneration or an injury, is also a possible cause. Furthermore, there are also less common causes, such as infections or tumours.

Who is affected by cervical radiculopathy?

Cervical Radiculopathy from a Herniated Cervical Disc – symptoms & causes

See my Maintaining disc health page for more information.

A cervical disc prolapse, bulge or herniation can occur, with no pressure on the cervical nerves. This may not give any pain at all, or just simple neck pain. If the nerve exiting the neck is pressured (irritated), however, neurological changes will occur with one or more of the following clinical signs.

Examination findings with a cervical nerve irritation:

• Tendon reflex changes
• Weakness and reduced muscle strength into the arms or hands
• Muscle atrophy if severe
• Reduced sensation, numbness, or hypersensitivity

Chiropractic Treatment of cervical radiculopathy

Chiropractors cannot just ‘put the disc back into place’, but treatment has been shown to reduce neck pain and arm pain, promote the healing process and speed up the recovery. A 2006 publication in The Spine Journal showed Chiropractic manipulation in the treatment of disc injuries and sciatica had “very good results”. In short, this article gave the green light for Chiropractic manipulation to treat cervical radiculopathy.

To treat this condition, chiropractors will employ a range of techniques:

• Chiropractic manipulation
• Joint mobilization
• Traction and muscle releasing treatments
• Deep massage to the muscular spasms and trigger spots
• Prescribe rest or activities to avoid strain
• Advise to avoid cervical extension or tilting the head back
• Educate clients, for example Alexander Technique focusing on neck and head balance to become more aware of neck extension
• Ice and/or heat therapy

Manipulation aims for radiculopathy

• Increase intervertebral space
• Widen cervical neural foramina
• Reduce inter-disc pressure
• Improve blood vascularity to site of injury

Muscular release of the Cervical spine

As a chiropractor, I may employ a range of techniques to right the cervical spine (the part of the vertebrae known as the neck). This could include:

Sub-Occipital Release (Chiropractic release using both hands). With fingertips on the base of the patient’s occiput, slow superior traction targeting the fascial tissue plane is applied, asking the patient to relax whilst holding the tender ‘trigger spots’. The fascial release can be felt as the tight connective tissue releases and the pain subsides.

Soft-Tissue massage to the paravertebral muscles along the cervical spine, given to the patients tolerance level.

Cervical traction with trigger point massage contact points to the mastoid processes, occiput, whilst the neck is in slight flexion

Muscle Energy deep cross-friction across the tendon insertions into the occiput and suboccipital muscles, asking the patient to relax whilst breathing.

Surgery should only be an option if you do not improve with other care, or if there is an urgent need to do so, for example, if you have compression of the spinal cord causing central stenosis.

How long it will take to get better is a unique process, depending on the duration of the symptoms, the severity of the injury and how well patients can avoid the daily stresses and strains to the neck that aggravate and irritate the condition. The good news is that most cases of cervical radiculopathy are self-limiting and go away on their own!