Before we go into how occupational/physical therapy can help with cervical radiculopathy, it’s important to explain what cervical radiculopathy is.
If you are at all worried about your neck pain or numbness in your hands due to cervical radiculopathy – I’ve written this blog with you in mind. I hope this answers some of your questions, concerns, or worries.
Not all of our clients come in with exactly the same problem, nor do they have the same goals.
If you have been diagnosed with cervical radiculopathy or you have neck pain and you THINK this sounds like you … request a free discovery visit to speak to our specialist after reading this blog if you are looking for answers on how therapy can help you specifically.
What Is Cervical Radiculopathy?
Cervical radiculopathy is often referred to as a “pinched nerve” in the neck, where the pain that may radiate down from the neck to the shoulder, shoulder blade, arm, or hand. Numbness, weakness and pain can happen throughout the arm and hand. The condition affects about 85 out of 100,000 people, and most often start presenting with symptoms in people in their 40-50s.
It often develops over time rather than a single injury. Anyone who sits for long periods, looks down at books or at computers, has jobs that use vibration types of tools, or over time loses motion in the neck region, also may be affected.
We have 7 cervical bones that make up your entire neck. Each vertebra is separated by a gel-like disc that provides shock absorption for the spine. The spinal cord connects to the brain and travels down through a canal in the vertebrae. Cervical spinal nerve roots branch off the spinal cord and go to specific locations in the arm. Cervical spinal nerves send signals from the brain to the arms to move and enable sensation in the arm and hands.
The spinal cord is like a tree trunk, and the spinal nerves are like the tree branches. If there is abnormal pressure on a branch near the trunk, everything along that branch will be affected.
What are the symptoms of cervical radiculopathy?
When the spinal nerves have pressure put on them, they cannot properly transmit messages from the brain to the muscles. Impinged nerves also will cause altered or absent sensation (feeling) in the arm along the route the nerve travels.
This is why a pinched nerve in the neck can cause pain, weakness, and loss of feeling all along the arm and hand.
Symptoms of cervical radiculopathy vary depending on where the compression is occurring. Typically, symptoms occur on the same side of the body as the affected nerve and may include:
You may feel pain that is described as “sharp,” “pins and needles”, “radiating”, and “burning” down the side of the arm.
You may have neck pain, shoulder blade pinching type of pain, shoulder pain. Pain also can radiate (branch out) into the wrist and hand following the path of the nerve branches.
The pain may feel dull ache, numbness/tingling, or an electrical sensation anywhere along the pathway of the nerve.
You may feel weakness in the shoulder, arm, or hand.
Your pain may worsen with certain neck movements. Often looking toward the ceiling and over the shoulder causes an increase in pain.
Symptoms that improve when lying down with the arm lifted over and behind the head. This movement may release some tension on the spinal nerve.
How is cervical radiculopathy diagnosed?
Most often, it’s in the clinical questions that a doctor or a skilled occupational therapist or physical therapist can ask that will rule in or rule out the diagnosis of cervical radiculopathy.
Having an MRI or CT can confirm neurologic compression and the extent of the compression. Oftentimes, EMG testing can help rule out compression at the elbow and wrist area. Though the EMG test has been proven to not be very reliable as it can give false positives – meaning it says you have a problem when the problem is not really there.
What Causes Cervical Radiculopathy?
Cervical radiculopathy may cause nerve compression to due:
- Wear and tear of discs with age.
- Herniated or bulging discs from trauma or degeneration (decline over time).
- Loss of motion and muscle imbalance.
- Other medical problems such as cancer/tumor.
- History of an accident years prior.
- History of lower back issues – even if you don’t currently have pain.
No matter “ the cause” – unless there is some other rare medical reason like cancer, it is possible to get rid of the pain and symptoms that you have radiating down your arm. Age and “arthritis” of the cervical bones are often blamed for the pain. There are many people who are older and have boney changes who do not live in pain and I want you to know that it is possible for you to explore as well.
That is, if you want to avoid taking pills, getting injections, and having surgery.
How is cervical radiculopathy treated?
Overall, cervical radiculopathy can be treated conservatively. There is little high-quality evidence on the best nonoperative therapy for cervical radiculopathy.
- Cervical collars may be used for a short period of immobilization during an acute phase. They are usually given out after accidents or from urgent care centers. Wear it too long and you will become stiff, causing more symptoms.
- Traction may temporarily decompress nerve impingement.
- Medications and nerve block injections will be most likely offered at the doctor’s office and may help alleviate pain and neuropathic symptoms.
- Occupational and/or Physical therapy can improve neck motion, improve muscle imbalances, and get rid of the symptoms.
Does occupational or/and physical therapy help radiculopathy?
The short answer is YES – therapy can help get rid of your neck pain, and the radiating pain and numbness that you may have running down your arm.
Finding a great therapist that will give you the time and attention to ask you questions, and get to the root cause of where the problem is, prescribe you to corrective movements that help, and follow up to progress you is key to getting rid of cervical radiculopathy pain.
Just like anything else, not all therapy and therapists are created equal. If you are committed to avoiding taking pills that don’t work. Or want to avoid getting injections and surgery – request to speak with our specialist.
Here at Hands-on Therapy Services, we’ll talk to you first and get a history and find out what is your most important goal. We will run through a comprehensive clinic testing to determine where the problems are, and find out which corrective movements work the best for you. Then we create a plan with you to help get rid of neck pain or the radiating numbness that is down in your fingers.
It is possible to get rid of cervical radiculopathy and the symptoms associated with it so that you can sleep through the night, drive your car without worrying about crashing, or work at your computer and not suffer through the day.
Does exercise help cervical radiculopathy?
If exercises are the “medication” to help cervical radiculopathy – getting the wrong dosage or the wrong medication can hurt more than help.
Exercises in the correct direction will help. With our method of evaluation and treatment, we can test which corrective movements give us the best results, so that we can give you a prescribed amount of exercises during the week.
The wrong exercises or doing them too HARD can either cause pain after the fact or not help at all.
Neck muscles and bones are very small and respond well to treatment. But the “no pain no gain” mentality does not work with this type of issue. Sometimes being very aggressive might feel good but then actually cause you pain later.
One way that we are unique in our approach to treating cervical radiopathy, is how we address the “above and below” to actually get you relief.
- We will address the thoracic spine (ie mid back) to make sure you are able to move your neck without pain.
- We will look at your shoulders and hands to see where there is tension and the nerves may be stuck causing you more aggravation.
- We will show you corrective movements that will help restore motion that may be lost and ease the tension and numbness of the nerves that go down your arm and hand.
There are several different phases that we address during your evaluation with us so that you can get lasting results.
What happens if cervical radiculopathy is left untreated?
Cervical radiculopathy left untreated will get worse over time. How much time? It can be months or even years.
Actually, if you have cervical radiculopathy, it ALREADY means that you have left it to get worse over time and NOW you may be looking up what to do and how to treat it because the pain is getting worse, and you may be more worried about numbness getting worse.
You can live with this problem for years and you may already have. The worse case scenario is that the pain gets so bad that you can’t sleep. The numbness causes you to be limited with holding items in your hands without dropping. You can’t feel your fingers unless you are looking at them which makes driving hard or even doing your buttons.
Our Patient Success Story
One of our clients has had issues with her neck and shoulders for 30 years. It took at least 2 years of the symptoms getting worse, worries of work, and being in her 60’s and thinking about retirement – to finally do something to help herself. It took her 6 months after she initially spoke to us…booked her cervical fusion surgery…then cancelled the surgery to come to see us here at Hands-on Therapy Services.
Since then, she is able to sleep, get in and out of bed without pain and numbness, works the computer without suffering, her arms going numb, and countless other activities that she was missing out on because of fear. Fear that she would become paraylzed at the slightest injury. Fear of not being able to continue running her business. Fear of what retirement would look like if she can’t move her head and arms.
There are several different phases that we address during your evaluation with us so that you can get lasting results. If you are committed to avoiding taking pills that don’t work. Or want to avoid getting injections and surgery – request a free discovery session.
When Cervical Radiculopathy Is Serious
Cervical Radiculopathy is always serious as it is pinching on a nerve, and how “bad” the symptoms are to you is when it becomes a serious problem.
In terms of therapy and the “no going back” serious – is when the symptoms start to change and become more permanent. Do you even want to consider that and wait for it to get so bad?
For example, when the numbness is constant, no longer coming and going any more. When you start to burn your fingers and not even realize that you have burned your fingers.
Another level of seriousness is when you start to lose muscle function, called muscle atrophy. Your nerves are like the electrical system of your body and when the wires get cut, the signals to the muscles to work, no longer work.
That’s how I usually describe it. And that is the worse case scenario.
If you are worried but scared to do anything because you are afraid of what therapy or surgery may do, consider talking to us first. There’s no commitment and no pressure. One thing we do really well at Hands-on THerapy Services, is to get your clear on what you can do before making any paid appointments. Even if you have tried therapy before, and got no relief, give us a call, schedule an appointment, OR request a Free Discovery Visit!
Written by Hoang Tran
About the author – Hoang Tran
Hoang Tran is a Miami certified hand therapist , the owner of Hands-on Therapy Services and author of the book “The Hands-On Approach”. She loves helping people with hand, neck and shoulder problems, because she knows how bad and debilitating they can get if not addressed and treated properly (once and for all!).
The aim of her occupational therapy practice in the Miami area is to bring patients back to full functionality, without pills, injections or surgery. Occupational and Physical Therapy are both offered at Hands-On Therapy by our experienced therapists who provide a comprehensive approach to your care. If you would like more information about the services give us a call at 786-615-9879 or visit handsots.com.
In these difficult times, we are here to help. Telehealth and online sessions are available!
The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.