Neck Pain w/ Radiating Pain (radicular)

Question 1

Clinical Presentation

Answer 1

• Neck pain with radiating pain in the involved extremity
• upper extremity dermatomal paresthesia or numbness, and myotomal weakness

Question 2

Tests & Measures

Answer 2

• Dermatomes
• Myotomes
• LMN reflexes: MSR & DTR
• UMN reflexes: clonus, hoffmans, babinski

——–Cluster—————-
- Cervical rotation ROM < 60 to involved side
- Distraction test
- ULNT1 median
- ULNT2 radial
- ULNT3 ulnar

Question 3

Exam Findings

Answer 3

• Neck and neck-related radiating pain reproduced or relieved with radiculopathy testing: positive test cluster includes upper-limb nerve mobility, Spurlings test, cervical distraction, cervical ROM
• May have UE sensory, strength, or reflex deficits associated with the involved nerve root

Question 4

Interventions (manual therapy)

Answer 4

• Supine gentle distraction manual traction
• supine cervical passive physiologic rotation mobilization
• supine lateral glide w/ ULNT 1 mobilization
• side glides
• Levator scapula post-isometric relaxation (PIR)
• Upper trap PIR
• Cervical paraspinals PIR
• relief with cervicoscapular muscle unloading
• median, radian, ulnar (slide/tension)