Experiencing a Pinched Nerve in Your Neck? Causes, Treatment, and Physical Therapy

Have you ever “turned the wrong way” or “slept funny” and felt pain in your neck? Or maybe you’ve unfortunately been involved in a car accident and had lingering pain in your neck, shoulders, arms, or hands? A pinched nerve, also known as “cervical radiculopathy,” is a condition that can present with a variety of symptoms. 

Regardless of how the symptoms present, having a pinched nerve in your neck can be a source of pain and disability that can significantly impact your ability to do your normal daily activities. In the blog post below, Laura Sullivan, PT, DPT, OCS, of Orthopaedic Hospital of Wisconsin Cedarburg Physical Therapy, describes the causes, symptoms, and treatment of a pinched nerve in the neck.  

Anatomy of the Neck  

Your spine consists of a series of bones called vertebrae that stack on each other and create a canal that protects your spinal cord. The neck, or cervical spine, is made up of seven vertebrae. Between the vertebrae are discs that act as shock absorbers during high-impact activities and also help maintain the space between the vertebrae where nerve roots exit the spinal cord. From the spine, the nerves then go to your upper extremities to allow them to perform movements, exhibit reflexes, and have sensory input. Eight cervical nerve roots exit the spine on each side.  

Causes of a Pinched Nerve 

So, what causes nerve impingement? In older adults, spine degeneration occurs as part of the normal aging process. As we age, discs lose height, bulge, and loose water content, becoming stiffer with bone spurs developing, which can impinge on the nerve roots. However, not all degeneration cases are symptomatic, with many individuals having these factors occurring but remaining asymptomatic.   

In middle-aged adults, impingement is often the result of a traumatic injury, causing a herniated disc where the disc bulges out toward the spinal canal. This injury puts pressure on the nerve root, which causes the symptoms of pain, weakness, and numbness/tingling. The cause of these types of injuries is often instances of lifting, pulling, bending, or twisting with a heavy, sudden load or a sudden force on the spine, such as a car accident.  

Symptoms of a Pinched Nerve Include:  

• Pain in the neck, shoulder, arm, and/or hand  
• Muscle weakness in the corresponding upper extremity   
• Sensory changes such as numbness and tingling that may also occur in the shoulder, arm, and/or hand  
• Loss of range of motion of the neck
   

Treatment for Pinched Nerves  

When deciding to seek treatment for neck pain, your physician or physical therapist will complete a thorough intake of medical history and general health. This process will help them to rule out if any other structures, such as blood vessels, are involved. Then, you will most likely perform different neck and/or upper extremity movements to recreate or alleviate your symptoms.  

Depending on the assessment results and reported symptoms, imaging such as an X-ray, MRI, CT scan, or EMG may be indicated. Imaging will often occur in severe cases where unbearable pain, increasing weakness or numbness, muscle wasting, or symptoms in the lower extremities exist.  

In most cases, physical therapy, non-steroidal anti-inflammatory drugs (NSAIDs), oral corticosteroid, or steroid injection is recommended to begin managing pain and improving mobility. When experiencing more severe symptoms, such as those mentioned above, surgery may be necessary to limit the long-term impact on your body.   

Physical Therapy  

When working with a physical therapist, they will address specific exercises geared towards:  

• Alleviating pain  
• Improving mobility of the neck, upper back, shoulder, and/or upper extremity  
• Strengthening the neck and upper quarter musculature    

A physical therapist may also utilize other modalities, such as cervical traction or dry needling to decrease pain and improve mobility. They will also help you to analyze aspects of your daily life, including:  

• Posture with daily and work activities and how they influence your symptoms (e.g. time spent sitting at a desk or looking at a screen)  

• Overall activity levels  
• Sleep quality and quantity  
• Stress/anxiety levels  

Modifications in these areas, when combined with specific exercises, can improve symptoms and get people back to their prior activities as soon as possible.  

If you are experiencing neck pain where treatment is required, our skilled providers and therapists will help you return to the activities you enjoy. To make an appointment, go online or call (414) 961-6800.