Cervical Nerve Impingement
Cervical nerve impingement, otherwise known to physiotherapists as cervical radiculopathy, is a condition where a nerve root exiting the spinal canal in the cervical spine is impinged or irritated. Impingement is like when a water hose is “pinched” along the way or something is pressing against it.
Shooting Pains Down the Arms
Due to the nature of the nerve supply, although the problem is in the neck, the symptoms complained can be felt further down the arm as the nerves supply both motor strength and sensation down to the hands. Common radiating symptoms complained by patients are described as “shooting pain”, “pulling pain”, and “tingling sensation”. In severe cases, patients may complain of weakness on the affected side.
The main causes of nerve impingement are degeneration and disc herniation. With ageing, the disc loses its water content, causing the space between vertebral bodies to narrow. The narrowed space presses down onto the nerves.
Also, the added pressure to the facet joints results in enlargement of the joints or development of bone spurs, which can also impinge on the nerve as it exits the foramina canal.
Poor control in the neck leads to increased pressure on the discs., such as unusual neck postures. Over time, with excessive load in the disc, the annulus (outer covering of the disc) may rupture, causing the contents of the disc to spill out of the disc. This is called a disc herniation. The contents of the disc can cause irritation to the nerves or reduce the space of the foramina canal.
What can physiotherapists do?
While the damage to the joints due to degeneration is irreversible, reducing muscle tightness and stiffness to offload the added pressure on the affected joints and discs should be a priority. Modalities such as cervical traction, ultrasound, and heat pack may also be used for symptomatic relief.
It is important for those with a history of cervical nerve impingement to strengthen their neck muscles, especially the deep neck flexors and extensors. These muscles are often found to be weak in patients with neck pain. Muscle balance in the neck has to be restored for the neck to move better without excessive loading in the joints.
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