If you have ever had neck pain and pain radiating down one arm, you may have a condition called cervical radiculopathy. Cervical radiculopathy occurs when a spinal nerve in your neck becomes pinched or compressed (commonly referred to as a pinched nerve). It can cause pain, weakness, and difficulty performing normal tasks like sitting, using your arms, or sleeping comfortably. Most episodes of cervical radiculopathy last for three to six weeks.1

In this article, we'll discuss how cervical radiculopathy is assessed and treated and what physical therapy exercises are commonly used.

 Pinched Nerves Are a Common Cause of Pain and Tingling

Physical Therapy Options for Managing Cervical Radiculopathy

Overview of Cervical Radiculopathy

Symptoms of cervical radiculopathy may include:1

Neck, shoulder, arm, and hand pain

Numbness in your arm or hand

Weakness in your arm, forearm, or hand

Tingling in your fingers

Difficulty moving your head normally

When To See A Doctor

If you have these symptoms, check in with your physician. They can determine which course of treatment you should take for your cervical radiculopathy.

Causes and Diagnosis

Diagnostic tests, including X-ray or magnetic resonance imaging (MRI), may be done to determine the cause of your pinched nerve.1 Causes of cervical radiculopathy may include:

Disc degeneration

Bulging or herniated cervical discs

Neck arthritis

Foraminal stenosis

Spinal tumor (although very rare)

Acute injury

Treatment

There are several treatments that your physician may recommend to treat your cervical radiculopathy. These may include:

Physical therapy

Physical therapy isn't for everyone with a pinched nerve in the neck. Some people have severe symptoms that require immediate medical attention. These symptoms usually include severe pain accompanied by paralysis in one arm. If that is the case, it is often necessary to visit a surgeon to quickly remove pressure off the nerve to get relief.2

Insurance Considerations

You may need a referral to see a surgeon and/or a physical therapist. Always check with your insurance company to determine if a referral is needed to ensure coverage.

Assessing Pinched Nerves in the Neck

When visiting a physical therapist for cervical radiculopathy, an initial assessment will be performed. First, a history will be taken, so be prepared to discuss your condition. When and how did it start? How is it changing, and what symptoms do you feel? What makes your symptoms better or worse?

Your therapist will also ask questions about previous treatments for your pinched nerve, and they will ask about medication you may be taking and about your past medical and surgical history.

The goal of history taking is to get a baseline idea of your condition and to ensure that progressing with a physical therapy examination is appropriate.

The physical therapy examination for cervical radiculopathy includes several components. Tests and measures may include:

Postural assessment

Assessment of deep tendon reflexes

Strength

Cervical range of motion

Tests of sensation (if you have numbness or tingling)

Neural tension tests

Repeated motion testing to see how your symptoms change with changing neck motion

After your examination, your therapist will have a good idea of what is causing your pinched nerve and what treatments should be done to help you gain relief. Your therapist will discuss with you a plan of care, and goals will be set for therapy.

Cervical Radiculopathy Physical Therapy

Your physical therapist may use various treatments to manage your cervical radiculopathy. The main goals of rehab for a pinched nerve are to restore normal neck motion, improve strength and posture, and give you a self-care strategy to get pressure off the nerve and keep pressure off the nerve. Most people with cervical radiculopathy work with an orthopedic physical therapist or one who is a musculoskeletal specialist.3

 How an Orthopedic Physical Therapist Can Help With Your Injuries

Physical therapy treatments may include some passive modalities meant to decrease pain or improve circulation to sore muscles. Cervical radiculopathy treatments may include:4

Heat

Ice

Massage

Postural instruction

Ultrasound

Electrical stimulation

Cervical traction

Manual therapy

Exercise

Keep in mind that passive treatments like heat or ultrasound may feel good, but there is limited research about their overall benefit in the treatment of a pinched nerve.2 Pinching of a nerve is a mechanical problem, and it often requires a mechanical solution, like exercise or manual therapy, to correct.3

Pinched Nerve Exercises

Exercise and postural correction should be your main tools in the treatment of your cervical radiculopathy. Exercise for your neck and shoulders can get pressure off the nerve, and postural correction may help keep pressure off the nerve.

Check In With Your Doctor

Before starting any exercise program for cervical radiculopathy, check in with your healthcare provider to ensure that it is safe for you to proceed.

If you have pain in your arm, monitor your symptoms as you exercise. If symptoms of pain and numbness or tingling get worse in your arm as you exercise, stop. This is a sign that the nerve is getting compressed more.

If arm pain decreases and shoulder blade or neck pain increase as you exercise, keep going. This is a phenomenon called centralization, and the centralization of pain that occurs as you exercise is a good sign.

Cervical Retraction

Cervical retraction, or the chin tuck, is an exercise that causes upper cervical flexion and lower cervical extension. This may relieve pressure from the nerves in your neck.

To perform cervical retraction, sit upright in a hard-backed chair. Pretend your head is on a shelf, and slowly draw your head backward, straightening out your upper neck. Your chin should tuck slightly as your neck slides backward. Be sure to keep your eyes level; your head should move straight back.

When your neck is pulled fully back, hold the position for three seconds, and then slowly release it. Repeat the neck retraction exercise for 10 repetitions, and do it three to four times each day.

Shoulder Rolls

Shoulder rolls can help relax upper and lower neck muscles and may improve your postural awareness. To perform the exercise, sit upright in a chair, and then slowly lift your shoulders straight up to your ears. Then, roll your shoulders backward, pinching your shoulder blades behind you as you roll.

Relax, and then repeat the exercise for 10 repetitions. This exercise can be done several times each day to relax muscles and improve postural awareness.

Cervical Rotation

To improve overall neck mobility, cervical rotation may be prescribed by your therapist. To perform the exercise, sit upright in a chair, and then turn your head to one side as far as you can. Once you are at the end of the range, hold the position for a few seconds, and then return your head to the neutral position. Repeat the exercise 10 times to one side, and then 10 times to the other side.

Neck Tilts

Neck tilts are a great exercise for cervical radiculopathy caused by arthritis or stenosis. To perform the exercise, sit in a chair and slowly tilt your neck forward as far as possible. Hold the position for three seconds, and then return to the neutral position. Repeat 10 times.

Your therapist may have you tilt your head to one side, too. To do this, sit upright in a chair, and bend your neck to the side, bringing your ear toward your shoulder. Hold the position for three seconds, and then return to the upright, neutral position. Repeat 10 times. You can repeat the side neck tilt for the other side, or your therapist may have you bend in only one direction to relieve a pinched nerve in your neck.

 Physical Therapy Can Help You Recover More Quickly From Injury

Prevention

As your symptoms abate, your physical therapist can show you what to do to prevent future episodes of pain. Cervical radiculopathy prevention strategies often include:

Improving posture

Strengthening muscles that support your neck and shoulders

Performing daily cervical range of motion stretches

Engaging in regular physical activity

If you have another episode of cervical radiculopathy, the neck exercises that your therapist prescribed during your first episode may be used to quickly relieve pressure from the pinched nerve to help you get rapid relief.

Outlook

Most episodes of cervical radiculopathy last for three to six weeks. Some severe cases may take up to eight weeks to fully recover.5 If your pain lasts longer than that, you may want to check in with your physician. Other treatments, like steroid injections or surgery, may be necessary for you to get full relief of your pain.

Your physical therapist should be continually assessing your response to treatment. If there is a significant worsening of your pain during your episode of care, they should refer you back to your physician for assessment. And if things are progressing as planned and you are improving, expect to be back to normal within a month or two.

A Word From Verywell

Cervical radiculopathy is a condition that causes pain, weakness, numbness and tingling, and loss of mobility in your neck and arm. Conservative treatments, like physical therapy, can help get pressure off spinal nerves, which will relieve pain and improve motion in your neck and shoulders. Working with a physical therapist can help you quickly and safely recover from cervical radiculopathy.

FREQUENTLY ASKED QUESTIONS

What kind of physical therapy helps with cervical radiculopathy?

Most people with cervical radiculopathy visit an orthopedic specialist physical therapist. A therapist with experience treating spinal conditions is a good resource for treatment. Some physical therapists are certified in the McKenzie Method. This method has been shown to be effective in treating the mechanical signs and symptoms that come with a pinched nerve.

How much physical therapy is needed for a pinched nerve?

Most people with cervical radiculopathy attend therapy two to three times a week for three to six weeks. As you improve, your visits to the therapy clinic should decrease and you should be more and more independent with the self-care management of your condition.

What can physical therapy do for a pinched nerve?

A pinched nerve is a mechanical problem in your neck; something is compressing a nerve and causing pain, weakness, or tingling in your arm. Physical therapy can be an effective treatment to help relieve pressure from the nerve. This can make your pain go away and stay away. Your physical therapist can also teach you what to do to prevent future episodes of cervical radiculopathy through exercise and education.