A pinched nerve is medically known as cervical radiculopathy, as travel physical therapy specialists may be aware. It is characterized by radiating pain in the upper body, from the neck to the shoulder, shoulder blade, arm or hand. An average of 85 out of 100,000 people are affected by this condition, according to the American Physical Therapy Association.
The people most affected by this problem are athletes, heavy laborers and workers who use vibrating machinery. People who sit for long periods of time can also struggle with pinched neck nerves, which is different from narrowed neck arteries.
Conservative care brings physical therapy, which can help alleviate symptoms, to the forefront. As a PT professional, you can reduce the acute neck and arm symptoms associated with pinched nerves, as well as improve general strength and function. This method has been so effective that most cases of cervical radiculopathy are resolved with PT and do not require surgery.
Cervical radiculopathy explained
Cervical radiculopathy occurs when a nerve root near the cervical vertebrae becomes compressed. This compression may happen for several reasons, but most frequently it occurs as the result of arthritis or decreased disc height in the neck region. In middle-aged people, normal degenerative changes in the discs create pressure on the nerve roots. In younger patients, cervical radiculopathy typically is caused by a ruptured disc, perhaps as a result of trauma.
Damage to nerve roots in this area can cause pain and the loss of sensation in the upper extremities, depending on where the damaged roots are. Neck pain can limit patients' ability to turn their heads, look up or down, or perform routine activities such as sleeping or exercising.
Symptoms
When travel physical therapy professionals see a patient with a pinched neck nerve, the main symptom is pain that spreads into the arm, chest, upper back and shoulders. A person with this condition may have tingling in their fingers or hands or a muscle weakness. Other symptoms include lack of coordination in the hands.
According to the American Physical Therapy Association, these symptoms may also be specific to the nerve root involved:
- C5 nerve root (between cervical vertebrae C4-C5): weakness in the deltoid muscle and upper arm; shoulder pain and numbness
- C6 nerve root (between cervical vertebrae C5-C6): weakness in the bicep muscle and wrist muscles; numbness on the thumb side of the hand
- C7 nerve root (between cervical vertebrae C6-C7): weakness in the triceps muscle; numbness and tingling in the back of the arm and the middle finger of the affected hand
- C8 nerve root (between vertebrae C7-T1): numbness in the little finger, weakness with hand grip
Cervical traction
The proper course of action that a PT specialist might take is gentle cervical traction and mobilization to reduce pain. Cervical traction is used to decrease compressive forces in the neck, which can remove pressure from the discs and open spaces where nerves exit the spinal canal, helping to relieve pressure from the compressed nerve. There are several different ways to use neck traction:
Mechanical cervical traction involves using a harness that attaches to the patient's head and neck while he or she is laying down on their back. The harness is connected to a machine that provides a traction force. Those on physical therapy jobs will operate the control panel to manage the amount of force applied.
You can also perform manual cervical traction, where you hold up the neck and head in your hands and gently provide a pulling force to the neck area. Rhythmic periods of pulling and resting are typically applied, with each position being held for up to 10 seconds.
The third type of traction is over-the-door traction, which you may prescribe to a patient so he or she can perform the exercises at home. As you may know, it requires the patient to strap a harness to the head and neck while sitting in a chair. The harness attaches to a rope that's strung through a pulley system over the door, and traction force is manipulated with weights on the opposite end of the rope. This can be an effective method for home remedies.