Cervical Radiculopathy

Understanding Cervical Radiculopathy

Also known as: Pinched Nerve in Neck, Cervical Nerve Root Impingement Cervical radiculopathy is nerve-root irritation in the neck that sends pain, numbness, or weakness down the shoulder, arm, or hand in a dermatomal pattern. The most commonly affected levels are C5-C6 (the C6 root) and C6-C7 (the C7 root). The underlying source is typically a disc herniation or foraminal stenosis narrowing the nerve's exit tunnel. Conservative care resolves the majority of cases — and in my clinical experience, patients are often surprised by how much improvement is possible without injections or surgery.

The pain spreads from the neck across the shoulder and down the arm, with numbness or tingling in specific fingers: thumb and index for C6, middle finger for C7, ring and pinky for C8. Weakness can appear in the biceps, wrist extensors, or grip depending on the level. Two classic clinical signs are worth knowing: Spurling's test, where extending and rotating the neck reproduces arm pain, and Bakody's sign, where resting your hand on top of your head relieves it. Symptoms often worsen with prolonged sitting, driving, or looking down at devices — postures that compress the cervical foramen.

Disc herniation and degenerative foraminal narrowing lead the list of causes. Forward-head posture, previous whiplash, repetitive overhead work, and cervical osteoarthritis all contribute. Heavy manual labor and contact sports raise risk, as does sleeping with a pillow that puts the neck in a compromised position for hours at a time. Cervical traction and motorized decompression are first-line — they open the foraminal space and reduce nerve compression.

We use gentle, low-force adjustments or Activator when a fresh disc is inflamed, advancing to diversified cervical manipulation as the nerve calms. Thoracic manipulation has strong evidence for cervical radicular symptoms — regional interdependence at work again. We release scalene, pec minor, and upper trapezius tightness that contributes to "double crush" patterns (where nerve irritation in the neck compounds wrist compression). Nerve glides, deep neck flexor training, and scapular strengthening complete the plan.

Class IV laser accelerates inflammation resolution. Most patients improve in six to twelve weeks. We may recommend: cervical/lumbar traction, spinal decompression, Activator, myofascial release, Class IV laser, corrective exercise, ergonomic coaching Seek immediate care if: You develop progressive arm weakness, loss of hand coordination, trouble walking, balance problems, or bowel/bladder changes — these could indicate cervical myelopathy needing urgent evaluation.