Monday 4 March 2019

Cervical Radiculopathy

Radiculopathy can be quite painful. The condition is commonly referred to as a pinched nerve, with pain, weakness or numbness spreading down the arm.The term radiculopathy comes from radix = “root”, with the nerve root being the common site of nerve pinching. Because this compression, you can feel the pain through the nerve pathway according to the nerve roots involved.


Causes:

A radiculopathy generally occurs with irritation of the nerve root as it exits the spinal column. This irritation can be due to a number of reasons including:

  • physical compression of the nerve from a bulging disc or bony growth (osteophyte) at the edge of the vertebra, tumour, fracture . etc
  • chemical irritation from swelling around the nerve root .

Symptoms of a Cervical Radiculopathy:

Pain is the most common symptom, with the worst pain often being felt further away down the arm.
Commonly  pain referral patterns in accordance with compression of nerves at different levels of the cervical spine.
Compression of the nerve may also lead to impaired nerve function, meaning that you made have areas of reduced sensation in the arm, or reduced power in muscles supplied by the compressed nerve.

Diagnosis:

Your physiotherapist is skilled at determining which structures may be causing your neck and arm pain. There are certain questions that they may ask you to help narrow down the diagnosis and this helps to guide a hands-on assessment. Your physio will palpate the muscles and joints around your neck, as well as perform testing of the nerves.If further investigation is required an MRI is the best way to diagnose a cervical radiculopathy, however, a CT scan or X-ray can still help with diagnosis.

Cervical Radiculopathy Treatment:

Pain Relief. Minimise Swelling & Injury Protection ( Phase 1)

Managing your pain. Pain is the main reason that you seek treatment for this condition.
Managing your inflammation. Inflammation it best eased via ice therapy and techniques or exercises that deload the inflammed structures.
Your physiotherapist will use an array of treatment tools to reduce your pain and inflammation. These include: ice, electrotherapy, soft tissue massage, joint mobility techniques and use of taping techniques or an arm sling to off-load the injured structures.

Restoring Normal ROM & Posture (Phase II)

Once  your pain and inflammation settles, your physiotherapist will turn their attention to restoring your normal joint range of motion (ROM), muscle length, neural tissue mobility and resting muscle tension.
Treatment may include joint mobilisation and alignment techniques, massage, muscle stretches and neurodynamic exercises, plus acupuncture, trigger point therapy or dry needling. Your physiotherapist is an expert in the techniques that will work best for you.

Restore Normal Muscle Control & Strength (PHASE III)

Your physiotherapist will assess your muscle recruitment pattern and prescribe the best exercises for you specific to your needs.
Physiotherapists has developed their own rehabilitation programme to assist their patients to regain normal muscle control of the neck and shoulders. Please ask your physio for their advice.

Restoring Full Function (PHASE IV)

During this stage of your rehabilitation is aimed at returning you to your desired activities. Everyone has different demands for their bodies that will determine what specific treatment goals you need to achieve. For some, it may simply be to walk around the block. Others may wish to do boxing classes or return to a labour-intensive work.

Your physiotherapist will tailor your rehabilitation to help you achieve your own functional goals.

Preventing a Recurrence (PHASE V )

Injury and the pain associated does have a tendency to return. The main reason it is thought to recur is due to insufficient rehabilitation.Your physiotherapist is an expert at identifying underlying joint restrictions and poor muscle patterning, and can help you to work on these to prevent recurrence.

Expecting Results :

Disc and nerve injuries can take a while to recover as the blood flow to these structures can be poor, meaning healing takes longer. Generally, an acute radiculopathy will feel much better in one to two weeks, with resolution by three months. Some cases will take longer, with slower improvements for up to six to twelve months.

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