Cervical radiculopathy (CR) results from the irritation or compression of a nerve root where it exits the cervical spine, often called a pinched nerve in the neck. This compression causes symptoms that radiate away from the neck and into the shoulder, arm, or hand. Chiropractic care offers a non-surgical, conservative approach aimed at addressing the mechanical causes of nerve irritation. This article explores how a doctor of chiropractic diagnoses and manages this condition, and the factors determining a patient’s suitability for this care.
Understanding Cervical Radiculopathy
Cervical radiculopathy occurs when a nerve root in the neck is compressed or inflamed, leading to neurological dysfunction. Symptoms include sharp or burning pain radiating down the arm along the affected nerve path. Patients often experience tingling, numbness in the hand or fingers, and sometimes muscle weakness in the shoulder, arm, or hand, reflecting motor nerve impairment.
The most common cause of nerve root compression is age-related degenerative changes, known as cervical spondylosis. As discs lose height and stiffen, the body may form bone spurs (osteophytes) to stabilize the spine. These changes narrow the foramina, the openings through which nerve roots exit, causing foraminal stenosis. In younger individuals, a sudden injury may cause a disc to bulge or herniate, placing direct pressure on a nerve root.
Chiropractic Assessment and Diagnosis
A Doctor of Chiropractic (DC) begins the assessment with a detailed patient history to understand the onset, location, and nature of the radiating symptoms. This history helps determine if the pain follows a specific dermatomal pattern, corresponding to a particular compressed nerve root. The physical examination checks the neck’s range of motion and observes how certain movements reproduce the patient’s arm symptoms.
A neurological screening evaluates the function of the compressed nerve root by testing deep tendon reflexes, muscle strength (myotomes), and sensation (dermatomes) in the affected limb. Orthopedic tests, such as Spurling’s test, are used to reproduce symptoms by extending and rotating the head toward the affected side while applying gentle downward pressure. A positive result strongly suggests nerve root compression. The DC may also review diagnostic imaging, such as X-rays or Magnetic Resonance Imaging (MRI), to visualize the underlying cause, like a disc herniation or bone spurs, before proceeding with treatment.
Specific Chiropractic Techniques for Relief
Chiropractic care focuses on restoring normal joint mechanics and reducing pressure on the irritated nerve root. This often involves spinal adjustments, specifically gentle, low-force mobilization techniques in the cervical spine. These controlled movements aim to improve alignment and restore proper movement to the neck joints, indirectly reducing nerve irritation.
Cervical traction is another frequently used intervention, applied manually or with a mechanical device. Traction gently stretches the neck to create negative pressure within the disc space. This may help retract a bulging disc or widen the neural foramen, relieving pressure on the nerve root. This mechanical separation can be highly effective in acute cases of radiculopathy.
Soft tissue therapies, such as trigger point therapy or therapeutic massage, address muscle tension and spasms accompanying nerve irritation. These techniques help reduce muscle guarding and improve blood flow, promoting a faster healing response. Chiropractors also prescribe specific therapeutic exercises and postural advice to stabilize the neck and prevent future recurrence. Exercises focus on strengthening deep neck flexors and scapular stabilizers to support the cervical spine.
Determining Suitability and When to Seek Specialist Referral
Chiropractic care is appropriate for patients with mild to moderate cervical radiculopathy who do not have severe neurological deficits. Most cases respond favorably to conservative, non-surgical management over several weeks to months. A typical recovery timeline often shows subjective improvement within six weeks, though full resolution of symptoms like numbness or weakness may take longer, sometimes up to five months.
Patients and chiropractors must recognize “red flags” signaling the need for immediate referral to a medical specialist, such as a neurosurgeon or orthopedic surgeon. These warning signs include progressive motor weakness, suggesting worsening nerve damage, or signs of cervical myelopathy (spinal cord compression). Myelopathy symptoms include clumsiness in the hands, gait instability, or new changes in bowel or bladder function. Other red flags warranting urgent investigation are unrelenting pain that disturbs sleep, fever, or unexplained weight loss, as these may suggest an underlying infection or malignancy. If symptoms persist beyond four to six weeks despite conservative care, specialized imaging or consultation should be considered.