Introduction
Cervical radiculopathy is a condition in which a cervical nerve root becomes compressed or irritated, often due to cervical spondylosis or disc degeneration. This compression can lead to neck pain that radiates into the shoulder, arm, or hand.
Physiotherapy plays a crucial role in the management of cervical radiculopathy because it focuses on reducing nerve irritation, restoring cervical mobility, and strengthening supportive muscles around the spine.
Early intervention helps prevent long-term functional limitations.
Case Presentation
A 42-year-old office worker presented with complaints of neck pain radiating to the right arm for the past three weeks. The pain increased after prolonged computer work and improved slightly with rest.
The patient reported additional symptoms such as:
- Tingling sensation in the fingers
- Occasional numbness in the forearm
- Difficulty turning the neck to the right side
- Increased discomfort during prolonged sitting
There was no history of trauma or recent injury.
Clinical Assessment
Subjective Examination
During history taking, the patient reported that symptoms worsened with prolonged forward head posture while working on the computer. Pain intensity increased by the end of the workday.
The patient also described occasional headaches associated with neck stiffness.
Objective Examination
Physical examination revealed:
- Reduced cervical rotation and side bending
- Positive Spurling test, suggesting nerve root irritation
- Mild weakness in wrist extensor muscles
- Increased muscle tightness in the upper trapezius
These findings indicated cervical radiculopathy likely related to degenerative cervical changes.
Physiotherapy Management
The physiotherapy management plan focused on reducing nerve compression and restoring normal cervical mechanics.
1. Pain Reduction
Initial treatment aimed to reduce pain and muscle tension. Techniques included:
- Gentle cervical mobilization
- Soft tissue release for tight neck muscles
- Application of heat therapy for muscle relaxation
These interventions helped decrease muscle guarding.
2. Postural Correction
Postural education was essential because prolonged forward head posture contributed to nerve compression.
Patients were advised to:
- Maintain neutral head alignment
- Adjust workstation ergonomics
- Take regular movement breaks during computer work
Improved posture reduces stress on cervical structures.
3. Therapeutic Exercises
Exercise therapy formed the core of rehabilitation.
Exercises included:
- Deep neck flexor strengthening
- Cervical range-of-motion exercises
- Scapular stabilization exercises
- Neural mobilization techniques
These exercises improve cervical stability and reduce nerve irritation.
4. Functional Rehabilitation
As symptoms improved, functional exercises were introduced to restore daily activity tolerance. Gradual strengthening and posture training helped the patient return to normal work activities.
Outcome
After four weeks of structured physiotherapy, the patient reported significant improvement in pain and mobility. Arm symptoms reduced considerably, and the patient was able to resume regular work with improved posture awareness.
Conclusion
The physiotherapy management of cervical radiculopathy focuses on reducing nerve compression, improving cervical mobility, and strengthening supportive musculature. Early rehabilitation combined with ergonomic correction can significantly improve patient outcomes and prevent recurrence.