Cervical Radiculopathy Treatment
Non-Operative Treatment of Cervical Radiculopathy: A Three Part Article from the Approach of a Physiatrist, Chiropractor, and Physical Therapists
Ross Hauser, MD, Batson G, Ferrigno C. Non-operative treatment of cervical radiculopathy: a three part article from the approach of a physiatrist, chiropractor, and physical therapists. Journal of Prolotherapy. 2009;1(4):217-231.
The painful condition resulting from soft tissue damage and degenerative disc changes causing pressure on a cervical nerve root is called cervical radiculopathy. It often produces agonizing neck pain, a burning sensation, along with numbness radiating down the arms, shoulder blades, and back, or up into the head. Authors discuss cervical radiculopathy from the position of a Physiatrist (R.H.), chiropractor (G.B.), and physical therapist (C.F.). Each author reviews case studies and techniques utilized in order to successfully treat patients presenting with cervical radiculopathy.
Cervical radiculopathy refers to a pinching or inflammation of a cervical nerve at its exit point in the spine, called the neuroforamen. It is caused by lesions that narrow the space in the neuroforamen, including cervical disk herniations, but more commonly occurs with cervical spondylosis.1,2 This latter condition refers to a gradual wear and tear or age-related degenerative changes.3 Many of these changes can be diagnosed or identified on conventional X-rays and MRI’s and may include narrowing of the disc space, bulging of the contour of the disc, herniation of the disc, calcification of the disc, and vertebral margins that result in spurs. (See Figure 1.) When the spurring significantly narrows around the nerve root exit passage or foramen it is referred to as neuroforaminal stenosis. These degenerative changes can lead to constant or episodic waves of pain. The symptoms of cervical radiculopathy typically include severe neck pain with radiation of the pain to the back of shoulder blade, shoulders, arm, or hand. Numbness or weakness in the arm can also be present.