Mississauga Chiropractor Presents: Cervical Radiculopathy

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Categories: Lecture Series

Here’s another blog from a Mississauga Chiropractor…

 

A Cervical Radiculopathy is a neurocompressive disorder of the cervical nerve roots resulting in various neurologic findings.  It most commonly affects the C7 (60%) & C6 (25%) nerve roots.

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Potential Causes:

  • Younger Patients:
    • Disc Herniation:  an acute injury causing foraminal impingement
    • Sports Injuries:  Forced extension, lateral bending or rotation of the neck

 

  • Older Patients:
    • Intervertebral foramen narrowing from osteophyte formation
    • Over the age of 40, there is a decreased chance of a disc herniation because the vertebral discs become fibrous with age
    • However, due to spinal canal stenosis with age, a small disc lesions in the elderly may have a greater clinical effect

 

Rick Factors:

  • Heavy manual labour requiring lifting more than 25 pounds (especially with repetitive activity)
  • Driving or operating vibrating equipment
  • Collision sports (e.g. football, hockey)
  • Prior injuries (MVA, whiplash), degenerative joint disease/osteoarthritis

 

History:

  • Patient may describe a deep aching to burning neck pain & radiating arm pain (“numbness, tingling, sharp, shooting, electrical”) that may follow a neck injury
  • May be a history of multiple episodes of previous neck pain
  • Possible muscle weakness in the arm/hand or sensory changes along involved nerve root
  • Patient will get symptom relief when shoulder is abducted with hand held behind the head

 

Presentation:

  • Patient exhibits a head tilt away from the side of injury & holds the neck stiffly
  • Patient movement towards side of injury (lateral flexion) may cause increased pain, numbness, tingling or shooting electrical pain
  • Limited cervical extension, rotation & lateral bending either towards or away from the affect nerve root.
    • Increased pain with lateral bending away from the affect side will indicate an increased displacement of the disc herniation upon the nerve root
    • Increased pain with lateral bending towards the affect side will indicate an impingement of the nerve root at the side of the disc space.

 

Treatment:

The goal is to reduce and centralize the pain and decrease inflammation in the area, as well as prevent further neurological loss.  In order to do this, it is critical to decompress the nerve root and attempt to reduce the herniation.

 

Reduce the herniation – McKenzie Extension Exercises

1)      Chin Tuck

2)      Chin Tuck & Neck Extension

3)      Chin Tuck & Neck Extension/Lateral Flexion towards & away from affected side.

 

  • Patients should avoid aggravating loading & flexion positions.
  • Patients should also avoid sleeping positions where the head is in positions that open up the disc space causing further disc herniations.

 

Prognosis is excellent with proper treatment.  90% of the patients can be treated with conservative treatment and the patient should show progressive improvement over the first 6-8 weeks.

 

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