Cervical radiculopathy typically causes patients to have arm pain that is consistent with the particular nerve root that is being compressed. The most common cause is from a cervical disc herniation, which is called a “slipped disc” in layman’s terms. This pain may go into the shoulder area, down into the arm, or may extend all the way into the hand and fingers. The pain is typically burning and extremely irritating to patients. This article refers to treatment options for this diagnosis, not for other issues like tumors or fractures.
What treatment options are available? Here are ten, starting with the most radical.
1) Surgery. Neck surgery for a herniated disc causing radiculopathy is indicated if a patient is having motor weakness. It is unclear if motor weakness is watched for over 3 to 6 months if it will improve even after a successful decompression. If a patient undergoes unsuccessful nonoperative treatment for over six weeks and is still miserable, surgery is indicated as a quality of life decision.
2) Interventional pain management. Often times the disc herniation will go away by itself, by disintegration. One of the methods to avoid surgery in the meantime is an epidural steroid injection. It can bathe the nerve root in a soothing anti-inflammatory material and reduce pain, thereby making life tolerable while the piece of disc pushing on the nerve root slowly disappears.
3) Physical Therapy. PT can help a lot in patient suffering with radiculopathy. The patient may need an epidural injection first along with pain medication, but physical therapy can improve range of motion and decrease pain.
4) Spinal Decompression Therapy. This is a nonoperative intermittent traction treatment that is FDA cleared. It works extremely well for lumbar pathology and in addition has shown success in treating cervical radiculopathy. Typically the treatment entails 20 sessions.
5) Chiropractic Treatment. Cervical manipulation has been shown to be effective for neck problems and radiculopathy. The risks of cervical manipulation appear to be very low, with fatalities occurring less than one in a million times.
6) Narcotic Pain Medications. In acute situations, these can be extremely helpful. The pain from radiculopathy can be disabling, and these medications may allow the patient to be much more functional.
7) Non-narcotic pain medications. These include NSAIDS, acetaminophen, and neuromodulators like gabapentin. They can help just as much as narcotics for radiculopathy and should be first line treatment.
8) Muscle Relaxers. When patients have radiculopathy, muscle spasms are common. Helping settle those down may allow the overall pain scale for patients to drop.
9) Acupuncture. Acupuncture has been shown to be effective for a lot of neurologic and musculoskeletal issues, and radiculopathy is no exception.
10) Massage. This may help substantially with muscle spasms and relaxation.