Cervical radiculopathy, which is also known as a pinched nerve in the neck can cause pain,
numbness and tingling that goes down from the neck into the upper neck and shoulder area,
the shoulder itself all the way into the arm and into the hand and fingertips. Now
surgery is done for this at times. It's rare that people have surgery for this condition.
But what is common is people suffer with this problem. Sometimes for a year or more, maybe even
decades, we have seen patients in our clinic that had been suffering for this for 20 plus years. In
this video, I'm going to explain everything that you need to know to get back to being healthy
again and avoid surgery if you have cervical radiculopathy, or a pinched nerve in your neck.
So first let's define cervical radiculopathy. I want to make sure you know what that term means.
Cervical just means neck. So we're talking about this part of the spine, the neck,
the bones that are inside your neck. And then Riddick, the part of the radiculopathy word,
the Riddick part of the word means nerve root. So we're talking about the nerve roots,
these right here that I'm flicking, that come out in the side of the spine, opposite it just means
disease of so we're talking about the neck, nerve roots, disease, or disease of the neck nerve root,
however, you want to combine those few terms. Now the next question I get is,
how does cervical radiculopathy happen? Well, there's many different factors that
can contribute to cervical radiculopathy. Let me cover just a few here, it's usually C-5,
c-6 nerve roots that are involved. So it's about this area right here. And the number one thing
that is that people find on an MRI that causes cervical radiculopathy is a disc herniation. In
the neck, you have discs between all the bones. And if those are over pressurized and not kept
healthy for the long term, then they can put pressure on the nerve kind of on the inside
part of the spine there. And that can cause a radiculopathy sensation where you're having
pain down the arm numbness, tingling, but it can also come from stenosis and your neck.
But that's where the space is where the nerves travel within the bones of the neck,
those begin to narrow for a variety of reasons. Some of those reasons could be losing disc
height in the neck, and you'll lose disc height with problems like degenerative disc disease,
I'm trying to give you all these terms, because you might see all this on your MRI report.
Or you might find this on Google and kind of mix them all up. And really they all overlap
more than then they're different. But if you have degenerative disc disease, then that means the
disc height is shrinking down. And so it's going to close the space where the nerves come out.
That's why you would get a cervical radiculopathy. In addition to degenerative disc disease. Another
one is arthritis in your neck, there's joints on the backside of the spine, you have pairs of
the moneyed side. And right in this area, if those joints begin to thicken and move in appropriately,
because there's arthritis in them, they can also begin to affect the nerves in the area.
And some people develop bone spurs, when there's abnormal pressure going through the joints of the
spine, the bones will go through an overgrowth, and that's what develops a bone spur in response
to bad forces going through the spine. Usually, there's bone spurs, wherever
there's muscle attachments, or ligament attachments. And if you're over tensioning
certain muscles or ligaments, then the bones kind of start to grow extra. And if it grows too much,
it can start to put pressure on the nerve root. Now part of that is there's bad forces going
through the spine, maybe because of muscles. So there's this concept of muscle imbalances.
That's really at the root of this problem, which I'll speak more about the muscle imbalance because
that's really where you want to focus. I'll talk more about that towards the end of this video. Let
me just give you some more helpful information. First, let me tell you how cervical radiculopathy
is diagnosed. And if you haven't gone to the doctor, what signs and symptoms you might
look for in yourself to diagnose it. Well, number one, if you've gone to the doctor,
they're going to do an x ray and MRI very likely and based on what they find there.
If they find bone spurs, loss of disc height, disc herniations, those kinds of things,
then they may tell you that you have cervical radiculopathy based on the MRI findings, but if
you haven't had imaging done yet, maybe you're in the process of going to the doctor, or you
just saw your general doctor and they want to send you to the orthopedist or some specialist first,
before they give you a diagnosis that happens to hear the signs the classic signs of cervical
radiculopathy number one is going to be stiffness in the neck. It may not be the biggest symptom.
So it's not like a priority. I'm just going to starting top to bottom. But people often say they
have stiffness in their neck. They don't always say they have pain. But they do say it's kind
of stiff when it turned this way. But I can turn all the way that way no problem. And sometimes it
does hurt and sometimes it doesn't. What is more common though, is pain in this area right here,
kind of between the neck and the shoulder. This area right here upper trap is if you know
that term, the muscle that's in that area. And if you look at the skeleton here, let me move it just
a bit closer. What's in this area right here? are some ribs, here's your first rib and second rib,
and then your shoulder blades just away from that, of course your neck is right in the middle.
So it's in this area where these nerves travel over these first couple of ribs,
that's often where the pain can get referred to. If it's getting pinched up at the neck,
after that it can go, the pain can go down into your arm, it can be in the shoulder. In fact,
it can often be mistaken for a rotator cuff tear. There, I have seen patients here in the clinic
that had been diagnosed with a rotator cuff tear. And they've even had an MRI that showed that they
had a rotator cuff tear, I had one in particular that was scheduled for a rotator cuff repair
surgery. And after I checked her out, everything looked good as far as her shoulder function
muscles were operating well, the motion in the shoulder was all there, there wasn't really a big
problem in the shoulder mechanics and strength. It was just painful. And after I looked at the
nurse stuff up in the neck, there's a lot of stuff referring symptoms down. So we cancelled
surgery or put it on hold. And we started treating her for cervical radiculopathy. And the shoulder
pain got better. So this happens where you can have like a shoulder problem primarily, but it's
coming from a cervical radiculopathy issue. And the best way to tell it apart in case
you're thinking you might have a rotator cuff problem is to check your motion in your shoulder,
try raising your arm all the way up. And if it's painful to do that, lie on
your back and move your arm up like say in bed. And if you can pick up your arm and it has pretty
good range of motion, and each side moves about the same, then you have a pretty good chance of it
not really being primarily a rotator cuff problem, it may be more of a nerve problem, like from the
cervical radiculopathy issue. And another common sign with cervical radiculopathy is pain at night.
So people have difficulty falling asleep because it can't find a comfortable position for their
neck. And sometimes they'll wake up in the middle of the night as well. Because the pain
their neck might be very bothersome, or it might be pain in the shoulder or numbness and
tingling in the hands even pain in the hand. This can often be mistaken for carpal tunnel
syndrome to now let's talk about treatments for cervical radiculopathy. Now if you see
a general doctor for this, like your GP, your PCP type of doctor, they're probably
going to tell you to put ice or heat on your neck take over the counter pain medications.
They may prescribe you with prescription strength, pain medications, they can even
give you an injection in your neck area to help alleviate the pain. All of these
things are great to do if you're especially if you're having trouble sleeping at night
and just doing normal things because it's so painful. But it's not fixing the root problem.
It's just masking the pain. And so eventually we need to talk about that. But let me tell you
what else happens if medications aren't helping. If the injection isn't helping,
the doctor might at that point send you to a surgeon for a surgical consult,
they may also send you to physical therapy. If you go to the surgical console,
what they're going to tell you there is of course what medications they be taking, they
may try some medications first before they look at surgery. And if you're a surgical candidate,
then the options that are commonly given to people with cervical radiculopathy problems are two.
One is a laminectomy surgery, a laminectomy is where they cut off the back of the bone here
to alleviate pressure on the nerve root. And honestly, I don't know if it's just my area
where I practice or what I'm seeing. But I have not seen a laminectomy surgery done in
a long time I have seen those patients, it's just not commonly done in my area, I think.
But mechanically speaking, you need those bones, you need to make sure that you have muscle
attachments to those bones to make sure that your muscles are going to operate normally. So Removing
a section of bone from your spine, in my opinion is not a great idea, you better make sure that you
try everything else that you can naturally to heal this before you allow a doctor to go in there and
take a very important piece of your bones away. The second surgery that's more commonly done.
It's not super common is a fusion surgery. And that's what they'll put in rods and
screws to fuse two bones together so that they don't move. What this does is it helps
to bring control to the area. It's especially beneficial if the disc is extremely damaged,
and you're certain that the disc is not going to get any better, which there's a lot of
things that you can do to make discs better. But that fusion surgery allows for no movement
in the area so that it's not irritating the nerve roots. Now if you get referred
to physical therapy and you go to physical therapy, they're often going to recommend
doing stretches for your neck where you turn to your left and your right and range of motion
exercises where you have to bend forward and back and side to side and you're just going
all the different directions at some clinics. So have you hooked up to a rig or bands where
you're moving your neck against resistance in an effort to strengthen your neck muscles and
I've seen In some health care facilities that have patients dangle their head off
the end of the table, and go backwards like this, in an effort to decompress the neck,
there's also traction devices out there. And there's all kinds of shoulder exercises
that they may have to work on, you need to make sure that you're feeling consistently better.
If your symptoms are getting worse in physical therapy, please tell your physical therapist, tell
your doctor as well. And if you're not meeting any sort of improvements, even though you're talking
to them, then you need to go and find somebody who specializes in treating cervical radiculopathy.
Naturally, before you have surgery, because very often physical therapy clinics especially,
they're excellent at helping people that have just had surgery not so much though,
at people that are looking to avoid surgery. So they're not always going to be the best at helping
somebody do the right exercises that are taking pressures off in addressing the muscle imbalance.
Which brings me to my next point, the root problem of cervical radiculopathy is a muscle imbalance,
this concept of a muscle imbalance is not mainstream, your doctor has probably never
mentioned it to you, if you if you're in physical therapy have gone through it,
they probably haven't mentioned it either. Every now and then somebody will mention it,
but they're not really versed in it really know the details of muscle imbalances and
how they work. Now I'm going to explain to you very simply how a muscle imbalance is going to
affect cervical radiculopathy. In the neck on the front of the neck behind your throat,
you have deep neck flexor muscles, which are the primary stabilizing muscles for your spine.
In cervical radiculopathy, those muscles usually are very weak and are not offering good stability
to the spine. So it's not controlling the motions very well. This causes bad forces to begin to go
through the neck. And it doesn't usually cause problems right away. It's more gradual over time.
The reason why it's gradual is because if you don't have good strength in these neck muscles,
other muscles begin to compensate. There's some muscles on the sides called the scaling
muscles. Those scalene muscles come from the neck here and then they run down to
the first and second ribs on either side. If those scalene muscles are doing a lot
of extra work, they begin to pull and yank on the neck and it starts to compress the neck
bones down. That's what starts to build up bone spurs, arthritis, decrease the disc height and
cause disc herniations. And you can tell if you have a scaly muscle imbalance, if you simply feel
your collarbone right above your collarbone maybe an inch or so and poke in this area.
It's not this big muscle that pops out right there, it's to the outside of it just a bit.
That's where your scaling are a bit is tender there, if it's hard and those muscles are kind
of stiff, that is likely situation that you have this imbalance. And you need to start to
fix it to get to the root of the problem. Because if you have a surgery for this,
and you still have the muscle imbalance, it's just a matter of time before some neck problem returns
again, because it's being caused by that muscle imbalance. Now, this muscle imbalance because
it pulls up the ribs. And there's other issues that I'm not going into deep detail about here.
Like it affects the shoulder blade position in the ball and socket joints of the shoulders out
here too. But it starts to yank up because of those scalene muscles, they start to yank up the
ribs and where these nerve roots go, what's what we're talking about here, cervical radiculopathy,
these nerve roots all bunched together and go right here under the collarbone.
And if your scalenes are very tight and overused, because they're compensating for weak, stabilizing
muscles, that deep neck flexors, then they can actually pull your ribs here slightly up and
begin to crush your nerves farther away. So when somebody comes to us for cervical radiculopathy,
yeah, we're looking at the nerves up here, at the spine wherever they come off the neck.
But we also have to look at the rest of the nerve pathway in the ribs in the shoulder
and the ball and socket joint down the arm all the way to the hands and see
what other places you might be compressing the nerve. Because very often what we find
is the pressure on the nerve from the neck at the spine is not the majority of the problem.
And when we treat issues just a little further out, it tends to get tremendously better to
the point where people are saying, hey, I can sleep at night again. You know what,
I'm not worried about surgery anymore. I think my necks improving and we're getting more mobility
in the area. I'm feeling a lot better. I hope this muscle imbalance concept as
it pertains to cervical radiculopathy is making sense. I can tell you you're probably not going
to hear from your doctor from your surgeon even from your physical therapist. This is
a concept that specialists in the field are mainly aware about they're aware of how to
identify it and how to treat it properly. Hey, I hope this video was helpful for you
if you know somebody that is suffering from cervical radiculopathy please share This with
them if you're looking for more help with cervical radiculopathy we'll be releasing
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that you don't miss a thing thanks so much for watching I'll see you in the next video bye