As one of the few Hong Kong Spinal Physiotherapy clinics that specialises in Spinal Conditions, Cervical Radiculopathy is a common condition that our team excels at treating, often avoiding the need for surgical intervention.

So how do you know if you have Cervical Radiculopathy, and what is the best way to manage it?

Read what our Spinal Physiotherapist, Ryan Tan, has to say about this condition.

What is Cervical Radiculopathy?

Cervical radiculopathy, sometimes referred to as a "pinched nerve," is a condition resulting from the compression or irritation of one or more nerves in the cervical spine (the neck region).

This compression can lead to pain, weakness, or numbness that radiates down the shoulder, arm, and even into the hands and fingers.

The cervical spine consists of seven vertebrae, and any nerve root emerging from these vertebrae can be affected.

Anatomical image showing a nerve (in yellow) being pinched by a herniated, cervical disc.

Important - not everyone with ‘neck pain’ has cervical radiculopathy, only those that have certain co-existing symptoms are diagnosed as having Cervical Radiculopathy, and our Physiotherapists are well trained to detect them accurately.

How do you develop Cervical Radiculopathy?

The condition is typically caused by degenerative changes in the spine, such as herniated discs, bone spurs (osteophytes), or other age-related changes. However, it can also result from acute injuries, poor posture, or repetitive stress on the neck.

An experienced Physiotherapist, up to date with modern assessment and diagnostic skills will be able to not only diagnose this condition, but to also identify your individual contributing factors.

This will allow a tailored treatment and management plan that’s best suited to help you achieve long lasting results.

This is an image of a single vertebral level. In yellow, the nerve, is being pinched within the spinal canal by an Osteophyte.

Common Symptoms and Presentations

Recognizing cervical radiculopathy can be challenging due to the variety of symptoms it presents. Here are some of the most common signs that you might be experiencing this condition:

Neck Pain: Persistent pain in the neck that can range from a dull ache to sharp, burning sensations.
Radiating Pain: Pain that spreads from the neck into the scapula area, shoulder, arm, and even fingers.
Numbness and Tingling: A tingling sensation or numbness in the shoulder, arm, hand, or fingers.
Muscle Weakness: Weakness in the muscles of the shoulder, arm, or hand, making it difficult to perform everyday tasks.
Loss of Reflexes: Reduced reflexes in the arm and hand, which can be detected through a physical examination.

Image showing a clear atrophy of the left tricep compared to clients right side. This indicates a high likelihood of the C7 nerve root being affected.

Remember, having neck pain in isolation does not immediately mean you have radiculopathy, there needs to be some ‘hard neurological signs’ that would make a Physiotherapist diagnose you with the condition.

(Watch in full screen) Clear signs of a loss of triceps reflex, indicating a higher likelihood of the C7 nerve root being affected.

How do we treat Cervical Radiculopathy at Physiologic?

Our proven Physiotherapy approach combines manual therapy with specific exercise rehabilitation to address both the symptoms AND the underlying causes of the condition.

Most cervical radiculopathy conditions should improve significantly over the course of 3-9 months time, and a Physiotherapist can help guide you throughout your recovery journey.

‘Complete’ recovery could take up to 24 months!

Manual Therapy

Our spinal physiotherapist, Ryan Tan, uses a variety of manual therapy techniques to alleviate pain and improve mobility. These techniques include specific joint mobilisations, soft tissue massage and expert dry needling.

We do NOT advocate relying on manual therapy as a long term solution.

The role of manual therapy is to alleviate painful symptoms, and to provide our clients a window of opportunity to participate more comfortably, and consistently in their exercise rehabilitation.

Dry needling of the neck and shoulder, a common treatment modality our Spinal Physiotherapy team uses to help alleviate symptoms of Cervical Radiculopathy.

Exercise Rehabilitation

One of the common symptoms of radiculopathy is muscle weakness and wasting (atrophy), therefore it is imperative for our team to prescribe progressive, muscle strengthening exercises to combat further muscle loss.

And based on the assessment of the contributing factors to your injury, we ensure that all clients are also address other factors that have led to your condition, aiming to give you the best long term results that traditional physiotherapy may have overlooked.

Common areas we like to include in our programs are thoracic spine mobility, scapulothoracic stability and general upper body strength.

We find that rehabilitating Cervical Radiculopathy is most effective when addressing ALL factors that contribute to the condition. Here, we show a torch press that is primarily designed to improve scapulothoracic function, which has a direct relationship with the cervical spine.

Supporting Evidence for Physiotherapy

So - what’s the research behind choosing Physiotherapy as the first line treatment of Cervical Radiculopathy?

Overwhelming scientific research supports the conservative management of cervical radiculopathy through physiotherapy. Key studies include:

Persson et al. (1997): This study found that physiotherapy, including manual therapy and exercise, significantly reduced pain and improved function in patients with cervical radiculopathy. The results support the efficacy of a conservative approach in managing this condition .

Kuijper et al. (2009): This research demonstrated that structured physiotherapy programs, focusing on both neck and upper limb exercises, are effective in alleviating symptoms and improving the quality of life in patients with cervical radiculopathy. The study highlighted the importance of a tailored exercise regimen in the conservative treatment of this condition.

Rhee et al. (2007): A comprehensive review indicated that non-surgical treatments, including physical therapy, should be the first line of management for cervical radiculopathy. The review emphasized that many patients experience significant symptom relief and functional improvement through physiotherapy interventions .

ABOUT THE AUTHOR

Ryan Tan, the Clinical Director and Spinal Physiotherapist at Physiologic Hong Kong, brings over a decade of expertise in sports and spinal physiotherapy. He holds a Certificate of Spinal Manual Therapy (COSMT), an intensive qualification dedicated to advanced spinal care, as well as being trained in Osteopathic Spinal Manipulations (OMT).

Ryan’s extensive background includes working in renowned Complex Pain Clinics in London, where he specialised in managing complex spinal conditions, working closely with Pain Consultants & Spinal Neurosurgeons.

Here in Hong Kong, he collaborates with leading Orthopaedic Spinal Specialists to deliver comprehensive and effective treatments for individuals suffering from persistent Spinal (Neck and Back) Injuries. If you have a complex spinal injury that remains unresolved, contact us for a thorough and obligation-free assessment!

References:

Persson, L. C., Moritz, U., Brandt, L., & Carlsson, C. A. (1997). Cervical radiculopathy: Pain, muscle weakness and sensory loss in patients with cervical radiculopathy treated with surgical and nonsurgical methods. Spine, 22(2), 209-215.

Kuijper, B., Tans, J. T. J., Beelen, A., Nollet, F., & de Visser, M. (2009). Cervical collar or physiotherapy versus wait and see policy for recent onset cervical radiculopathy: Randomised trial. BMJ, 339, b3883.

Rhee, J. M., Yoon, T., Riew, K. D. (2007). Cervical radiculopathy. Journal of the American Academy of Orthopaedic Surgeons, 15(8), 486-494.

Understanding Cervical Radiculopathy: Symptoms, Causes, and Treatment