Cervical Radiculopathy

What is Cervical Radiculopathy?

Cervical radiculopathy occurs when a nerve in the neck is compressed or irritated, often by a disc herniation or arthritic changes in the spine. This can cause pain, numbness, or weakness that radiates from the neck into the arm.

Common Symptoms

• Neck pain that radiates into the shoulder, arm, or hand

• Tingling, numbness, or burning sensations

• Muscle weakness in the arm or hand

• Pain worsened by certain head or neck movements

Physical Therapist Diagnosis

A physical therapist uses a combination of neurological testing (reflexes, strength, sensation) and special tests such as the Spurling’s test or cervical distraction test. Observing posture and movement provides clues about how spinal mechanics may contribute.

Why it Happens

This condition is often caused by a herniated disc pressing on a nerve root, or by degenerative changes that narrow the space where nerves exit the spine. Poor posture, repetitive stress, and age-related changes are common contributors.

Why it Doesn’t Always Heal on Its Own

While some nerve irritation may improve over time, persistent compression can cause ongoing pain or weakness. Without treatment, function may decline, and compensations can create additional problems in the shoulder and upper back.

Ideal Physical Therapy Treatment

Treatment focuses on reducing nerve irritation, improving spinal mobility, and strengthening supportive muscles. While dry needling is not typically directed at the nerve itself, it may be useful in addressing secondary muscle tension that develops from guarding.

Key treatment strategies include:

• Manual therapy and traction to reduce nerve compression

• Targeted dry needling for muscle tension contributing to pain or guarding

• Postural correction and ergonomic strategies

• Strengthening of deep neck flexors and shoulder stabilizers

• Neurodynamic exercises to restore normal nerve mobility

• Progressive strengthening and mobility training for long-term resilience

Expected Outcomes

With guided therapy, many individuals recover full function and experience significant pain reduction. Addressing both the irritated nerve and the underlying movement issues provides the best long-term outcome.