• Chris Purcell

Don't be ridiculous

What if I told you that your shoulder blade and / or arm pain was coming from your neck?


If a nerve is mechanically compressed at what is known as the nerve root (which is where the nerve exits the spine in the neck) then it can cause pain and other symptoms. When it is only causing pain, this is often referred to as radicular pain. When it is causing, pain, pins and needles, numbness and or weakness then it is known as Cervical Radiculopathy.

The nerve root compression can be caused by a range of factors including cervical disc protrusion, osteophytes (think bony spurs) or stenosis (spondylosis). In many cases it is a combination of all three of these factors. Thorough assessment from a physiotherapist can usually determine the area in the neck where the nerve is believed to be compressed and can often also provide good advice on how severe any compression appears to be. In some cases, medical review and imaging might be indicated to clarify the severity of any nerve compression and there are some medications that can be prescribed by your doctor in some cases of severe nerve pain.


The good news is that in a majority of cases (approximately 80%), symptoms from cervical radiculopathy can be managed conservatively without any surgical intervention. Physiotherapy is effective, with the first aim of treatment to improve or restore range of motion in the cervical spine. Physio will also aim to settle down the irritated nerve using special exercises that address what is known as “mechanosensitivity” (think mobility and irritability of the nerve). Then once settled, physiotherapy will provide you with a program of strength work targeting the cervico-thoracic muscles (upper back and neck).


Typically our patients who present with cervical radicular symptoms are in a lot of pain at their first session. This often settles with treatment and rest across the first 3-4 sessions (1-2 weeks) with the whole treatment plan taking somewhere between 6-12 weeks to complete.


In many cases, before a severe episode of cervical radiculopathy, patients may experience one or two episodes of less severe neck and or arm pain of only a few days duration. Other things that might occur before a severe episode of pain is a generalised reduction in your neck range of motion. Stiffness usually presents before pain, so this is a great time to get in a see a physiotherapist for assessment and treatment. It is much quicker to settle down neck symptoms before the nerve becomes irritated.


Please reach out to us if you have any questions about your neck or arm / shoulder symptoms.



Yours in health

Chris from Out of the Box Physiotherapy



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