Cervical Radiculopathy: Diagnosis & Treatment

“Help, my shoulder hurts and I am getting pins and needles in my arm/hand, but I did nothing to my shoulder! All I do is sit at my desk and work on the computer all day!” 💻 This a very common complaint heard by physical therapists. 

It is not unusual for someone to believe they have shoulder/arm issues resulting in symptoms such as numbness, tingling, shooting pain and even weakness in the arm and be told that there is nothing wrong with their arm. Instead, they learn their symptoms are coming from their neck. Interesting, right?!

The condition presenting in such ways is called cervical radiculopathy and it is indeed, stemming from the cervical spine, aka the neck. 

Our cervical spine consists of seven vertebral bodies/bones, C1-C7, and between each vertebrae come out nerve roots, eight in total.  These branch out into smaller nerves and innervate the muscles in our neck, torso and upper extremities. They are also responsible for controlling  movements, sensations, and even breathing.

 

 

 

Sometimes, those nerve roots may become compressed, entrapped, irritated or the term that is most frequently heard, ‘pinched’ at the spine. Some of the reasons for this to happen could be due to disc herniations, narrowing of the spinal canal, or arthritic changes at the spine. At times, the cause of these conditions could simply be postural and found in persons who spend most of their time sitting and working on a computer, as slouching and looking down could irritate the nerve roots in the neck. In all cases, the cause is coming from the nerve root, but the symptoms can be felt in the shoulder and upper arm, shooting into forearm and sometimes even the finger tips, as these nerve roots control all of these body parts.

In addition to being mistaken for shoulder pain, cervical radiculopathy could also be misdiagnosed and mistreated for carpal tunnel, which often can happen in those working on the computers. 

Cervical radiculopathy can easily be diagnosed via imaging and utilizing their knowledge, screens, and manual tests, physical therapists can easily diagnose and treat such conditions.  Starting with patient education, postural corrections, muscle strengthening and/or stretching, as well as manual treatments, physical therapists have a high success rate with cervical radiculopathy treatments. Other means of treatments could include injections, medications and in worst case scenarios, surgery. 

So the next time you have an unexplained shoulder/arm pain ask yourself, could it actually be my neck that is causing the pain?

 

References

Sravisht Iyer ;Han Jo Kim.”Cervical Radiculopathy.” Current Reviews on     Musculoskeletal Medicine. Springer Science+Business Media.                New York: 2016.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4958381.

https://www.pediagenosis.com/2019/06/dermatomes-of-upper-limb-and-segmental.html

https://www.cervicaldisc.com/blog/anatomy-of-the-neck-causes-of-neck-pain-and-how-to-manage-the-pain

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