Cervical Radiculopathy ( Pinched Nerve )

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Cervical radiculopathy is a dysfunction of a nerve root of the cervical spine. The seventh (C7; 60%) and sixth (C6; 25%) cervical nerve roots are the most commonly affected.

In the younger po pulation, cervical radiculopathy is a result of a disc herniation or an acute injury causing foraminal impingement of an exiting nerve. Disc herniation accounts for 20-25% of the cases of cervical radiculopathy. In the older patient, cervical radiculopathy is often a result of foraminal narrowing from osteophyte formation, decreased disc height, degenerative changes of the uncovertebral joints anteriorly and of the facet joints posteriorly.

Risk Factors: include heavy manual labor requiring the lifting of more than 25 pounds, smoking, and driving or operating vibrating equipment. Injury to the cervical, debeties


Symptoms
Pain:Pain is a common symptom of a pinched nerve in shoulder. It might be sharp or burning, it could cover the whole shoulder area, or a specific spot. This depends on the location of the nerve. If it is close to the spinal cord and originating from the neck then neck movements may agitate it as well.

Numbing: Numbness or tingling can occur due to a pinched nerve in shoulder. You might get a feeling that your shoulder is dead, or when you touch it you don’t feel as much, there is less sensation. Pins and needles is another common complaint. It may occur any place between your hand to your neck and depends on where the nerve is being compressed.

Weakness: Since the nerve are what activates muscles, if one is being compressed, the signal to your muscle will be weak. You will therefore experience muscle weakness as a result of a pinched nerve in shoulder. You may experience it when you are reaching above your head to try to grab something, and occurs in different parts of the arm depending on the nerve location.

Muscle Spasms: Muscles spasms and twitching can occur as a result of a pinched nerve, especially one that is originating in the neck area.

  • C5- The main result of a pinched C5 nerve root is shoulder pain, weakness in the deltoid muscles, along with the possibility of a numb sensation in the shoulder area.                                                                                                             Weakness: shoulder abduction
  • C6 - The main result of a pinched C6 nerve is pain radiating down your arm and into your thumb. Other less common symptoms include weakness in the biceps and wrist muscles.                                                                                     Weakness:elbow flexion, wrist extension
  • C7 - The main result of a pinched C7 nerve is pain and numbness radiating down the arm and into the middle finger. Weakness:elbow extension, wrist flexion
  • C8- The main result of a pinched C8 nerve is a numb sensation or pain felt in the outside of the hand.                        Weakness: thumb extension, wrist ulnar deviation
Investigation:

X-Ray                                                                                                                                                                                         Spurling Test: Laterally flex clients head and apply a downwards compression force.


   

        Treatment For Cerivcal Radiculopathy

Medication:

ü  Nonsteroidal anti-inflammatories (NSAIDS). These include drugs like aspirin and ibuprofen, and may be helpful if the arm symptoms are from nerve swelling.

ü  Oral corticosteroids. A short course of oral corticosteroids may also help reduce swelling, as well as pain.

Soft Collars. Soft collars allow the muscles of the neck to rest and limit neck motion. This can help decrease pinching of nerve roots with movement. Soft collars should only be worn for short periods of time, because long-term wear can decrease the strength of neck muscles.

Physical Therapy Treatment:

1.        Apply a heat pack onto your shoulders and neck.

2.        Massage the neck and shoulder. Make sure that you don’t apply too much pressure. The massage should be light and gentle.

3.        Apply heat cream or herbs onto the affected area. Again, this doesn’t remove the cause of the problem but can give you plenty of relief.

4.        After about 10 -12 days, you can start Exercises. It helps strengthen and stretch the muscles, relieve pain and pressure, alleviate stiffness and improve the range of motion.

5.        Stretching Exercises

6.        Strengthening Exercises

 


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