Neck Pain w/ Radicular Symptoms

Question 1

What common symptoms are associated with neck pain w/ radiating pain?

Answer 1

• neck pain with radiating pain in the involved extremity

- upper extremity dermatomal paresthesia or numbness and myotomal muscle weakness

Question 2

What are the expected exam findings with neck pain w/ radiating pain?

Answer 2

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

Question 3

What types of patients commonly have radiating neck pain?

Answer 3

• patients with herniated disc in C-spine
• peripheralization/centralization patients
• present with dermatomal, myotomal and/or reflex changes
• pain with cervical rotation (over 60 deg.)
• pts with adverse neurodynamic mobility

Question 4

What four tests significantly increase the likelihood of a cervical radiculopathy if all 4 are positive?

Answer 4

• Ipsilateral cervical rotation under 60 deg.
• ULTT A
• Distraction test
• Spurling’s Test A

Question 5

What predictors will help determine who will benefit from interventions for cervical radicular symptoms?

Answer 5

• age under 54
• dominant arm not affected
• looking down doesn’t aggravate symptoms
• multi-modal Rx for over 50% of visits

Question 6

What is a common on/off cycle for intermittent traction? How much force is applied during the off cycle?

Answer 6

On time: 60 sec of pull force

Off time: 20 sec of relaxation force (50% of pull force)

Question 7

What are we looking for during exercises for neck pain w/ radicular pain?

Answer 7

Centralization