Cervical Radicular Pain

Question 1

What are the two main mechanisms of nerve root compression in the C spine?

Answer 1

• Spondylosis (leading to stenosis & bony spurs)

- Disc herniation

Question 2

What are the typical symptoms of cervical radiculopathy?

Answer 2

• Radiating pain in a dermatomal pattern
• Neck pain
• Parasthesia
• Muscle weakness in a myotomal pattern
• Reflex impairment/loss
• Headaches
• Scapular pain
• Sensory and motor dysfunction in upper extremities and neck

Question 3

What are the affected upper limb movements and which spina level do they correspond to?

Answer 3

C1/C2- Neck flexion/extension
C3- Neck lateral flexion
C4- Shoulder elevation
C5- Shoulder abduction
C6- Elbow flexion/wrist extension
C7- Elbow extension/wrist flexion
C8- Thumb extension
T1- Finger abduction

Question 4

What tests provocative tests are there for the cervical spine? please demonstrate them…

Answer 4

• Spurling’s test
• Upper limb tension tests (median, ulnar, radial)
• Cervical distraction test
• Involved side cervical rotation range of motion less than 60 degrees.
  (All four positive = 90% probability of cervical radiculopathy)

Question 5

What are the treatment options for cervical radicular pain?

Answer 5

1. Education and advice
2. Manual therapy (PAIVMs, PPIVMS, NAGS, SNAGS)
3. Exercise therapy (AROM, stretching and strengthening)
4. Postural re-education

Question 6

What is the most used measurement tool for neck pain?

Answer 6

Neck Disability Index