BCP Cervical Rediculopathy Flashcards
What three conditions can cause neck pain that radiates into the upper limb ?
- stenosis: narrowing of the spinal canal and foreman
- Radicular pain - pain that follows the nerve path
- Rediculopathy - pain that follows the nerve root and is accompanied by altered function ie. Tingling, weakness, altered sensation
At what level of the Cervical spine does Rediculopathy occur the most frequently?
C6/C7
Signs and symptoms of Cervical Rediculopathy?
- tingling, shooting, nerve type pain
- Typicallly uni-lateral (Bi-lateral might be Mylopathy red flag)
- Neck pain
- Peripheral limb pain (arm) worse than neck
- Sensory loss
- Upper limb strength loss
- Pain/ loss of ROM of neck and shoulder
What is the average age for developing Cervical Rediculopathy?
40-50
What tests might we use for Suspected Cervical Rediculopathy?
- ULTT
- Spurling’s Test
- Rotation test (more than 60%)
- Distraction test (relieving symptoms).
What are red flags that require urgent referral for Cervical Rediculopathy?
- Bilateral arm pain
- Altered gait
- Lack of reflexes
When would surgery be the first go to in Cervical Rediculopathy?
- when they have severe symptoms
- Loss of strength
- Loss of sensation
- Quality of life has gone down.
Does Surgery have a positive outlook if done sooner or later ?
- the prognosis is better if surgery is carried out faster
What is the average prognosis of Cervical Rediculopathy?
- 4-6 months
- 2-3 years with Neurological deficits to return
What type of manual therapy would we use with cervical Rediculopathy?
- light traction with rotations (THATS IT)
When would we do specific vs general exercises for suspected Cervical Rediculopathy?
- Specific would be later when symptoms have calmed down.
- General is for really early stages to get pro anti-inflammatory effects.
What early, low load exercises (Step 1) would you do for Cervical Rediculopathy?
- Facilitated prone PROM (twisting, lat flexion, extension, flexion )
- Movements with fingers as goals
What intermediate (Step 2) exercises would you give for Cervical Rediculopathy?
- isometric neck ROM against hands
- Isometric neck holds prone against gravity
What Advanced (Step 3) Exercises would you give for Cervical Rediculopathy?
- Neck rolls (towel on wall and pressing into wall, going on to tip toes)
- Floor neck rolls (pushing head into ground with body weight)
- Neck bridges (onto a box or bench, isometric and concentric)
Who should do Advanced neck exercises for Cervical Rediculopathy?
- Athletes or people who’s necks have high load, most people can stop at stage 2
