Cervical Radiculopathy MASTER CLASS for Physical Therapists – FPF Show E:115

By dpope2020

December 29, 2023

cervical pain, cervical radiculopathy, cervical radiculopathy chiropractic, cervical radiculopathy exercises, cervical radiculopathy physical therapy, cervical radiculopathy surgery, cervical radiculopathy symptoms, cervical radiculopathy test, cervical radiculopathy treatment, dan pope, dr. david middaugh, el paso manual physical therapy, fitness pain free, neck pain, neck pain treatment, nerve pain, physical therapist, physical therapy, pinched nerve, pinched nerve in neck

Cervical Radiculopathy MASTER CLASS for Physical Therapists - FPF Show E:115

To go along with today's episode I have a nice infographic to share...

Sign up to receive FREE: Cervical Radiculopathy - The Evidence Based Cheat Sheet

Click HERE to Download FREE

Grab the rest of the Mini Course and Sign up for the Certification Pre-sale list:

In today's video we go over a Cervical Radiculopathy MASTER CLASS for Physical Therapists - FPF Show E:115: 

  • 0:00 Introduction
  • 1:52 What is cervical radiculopathy?
  • 3:05 How common is cervical radiculopathy?
  • 4:30 Does cervical radiculopathy naturally improve with time?
  • 12:08 What increases your risk of having cervical radiculopathy?
  • 16:36 Relevant anatomy in cervical radiculopathy
  • 22:16 How does cervical radiculopathy occur? (mechanism of injury)
  • 28:18 History and clinical presentation of patients with cervical radiculopathy
  • 39:11 Objective examination key points for physical therapists (myotomes, dermatomes, reflexes, special tests)
  • 51:24 When to perform additional testing (MRI, X-ray, EMG, Nerve conduction velocity testing)
  • 57:28 Differential diagnosis of cervical radiculopathy
  • 58:32 Best exercise treatments for cervical radiculopathy
  • 1:14:41 Should we use a hard collar to treat cervical radiculopathy?
  • 1:16:06 Should we use cervical traction to treat cervical radiculopathy?
  • 1:17:38 Should we use manual therapy strategies to treat cervical radiculopathy?
  • 1:28:05 Should we use injections (corticosteroids) and / or surgery to treat patients with cervical radiculopathy?

Radiculopathy overload...

- Dan Pope DPT,OCS,CSCS

Show Notes / Relevant Articles:

Want to support me and decide topics for future episodes?  Click HERE to sign up for FPF "Insiders" for just a dollar. You'll gain access to 100+ webinars, e-books and complete guides.  Plus, you'll get private access to the "Insiders" Facebook group where you can have all of your questions answered by me.  

Looking for other ways to support me that are 100% free?

  • Like, comment and share on youtube, facebook and instagram 
  • Leave a 5-star review on apple podcasts

Thank you!

Dan Pope DPT, OCS, CSCS

References: 

  1. Peene L, Cohen SP, Brouwer B, James R, Wolff A, Van Boxem K, Van Zundert J. 2. Cervical radicular pain. Pain Pract. 2023 Sep;23(7):800-817. doi: 10.1111/papr.13252. Epub 2023 Jun 4. PMID: 37272250.

  2. Schoenfeld AJ, George AA, Bader JO, Caram PM Jr. Incidence and epidemiology of cervical radiculopathy in the United States military: 2000 to 2009. J Spinal Disord Tech. 2012 Feb;25(1):17-22. doi: 10.1097/BSD.0b013e31820d77ea. PMID: 21430568.

  3. Iyer S, Kim HJ. Cervical radiculopathy. Curr Rev Musculoskelet Med. 2016 Sep;9(3):272-80. doi: 10.1007/s12178-016-9349-4. PMID: 27250042; PMCID: PMC4958381.

  4. Wong JJ, Cote P, Quesnele JJ, et al. The course and prognostic factors of symptomatic cervical disc herniation with radiculopathy: a systematic review of the literature. Spine J. 2014;14:1781–9. doi: 10.1016/j.spinee.2014.02.032.

  5. Kazeminasab S, Nejadghaderi SA, Amiri P, Pourfathi H, Araj-Khodaei M, Sullman MJM, Kolahi AA, Safiri S. Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord. 2022 Jan 3;23(1):26. doi: 10.1186/s12891-021-04957-4. PMID: 34980079; PMCID: PMC8725362.

  6. Yabe Y, Hagiwara Y, Sekiguchi T, Sugawara Y, Tsuchiya M, Yoshida S, Tsuji I. Sleep disturbance is associated with neck pain: a 3-year longitudinal study after the Great East Japan Earthquake. BMC Musculoskelet Disord. 2022 May 16;23(1):459. doi: 10.1186/s12891-022-05410-w. PMID: 35578231; PMCID: PMC9109362.

  7. Rasmussen-Barr E, Grooten WJA, Hallqvist J, et alAre job strain and sleep disturbances prognostic factors for neck/shoulder/arm pain? A cohort study of a general population of working age in SwedenBMJ Open 2014;4:e005103. doi: 10.1136/bmjopen-2014-005103

  8. Kang KC, Lee HS, Lee JH. Cervical Radiculopathy Focus on Characteristics and Differential Diagnosis. Asian Spine J. 2020 Dec;14(6):921-930. doi: 10.31616/asj.2020.0647. Epub 2020 Dec 22. PMID: 33373515; PMCID: PMC7788378.

  9. Bogduk N. The anatomy and pathophysiology of neck pain. Phys Med Rehabil Clin N Am. 2011 Aug;22(3):367-82, vii. doi: 10.1016/j.pmr.2011.03.008. PMID: 21824580.

  10. Over DR. Provocative diagnostic testing for cervical radiculopathy. Am Fam Physician. 2010 Nov 1;82(9):1051. PMID: 21121546.

  11. Berry J A, Elia C, Saini H S, et al. (October 17, 2019) A Review of Lumbar Radiculopathy, Diagnosis, and Treatment. Cureus 11(10): e5934. doi:10.7759/cureus.5934

  12. Childress MA, Becker BA. Nonoperative Management of Cervical Radiculopathy. Am Fam Physician. 2016 May 1;93(9):746-54. PMID: 27175952.

  13. Hong CG, Nam WD. Reliability and Diagnostic Accuracy of Standard Dermatomes and Myotomes for Determining the Pathologic Level in Surgically Verified Patients With Cervical Radiculopathy. Neurospine. 2022 Dec;19(4):1006-1012. doi: 10.14245/ns.2244194.097. Epub 2022 Dec 31. PMID: 36597659; PMCID: PMC9816603.

  14. Hasvik E, Haugen AJ, Grøvle L. Pinprick and Light Touch Are Adequate to Establish Sensory Dysfunction in Patients with Lumbar Radicular Pain and Disc Herniation. Clin Orthop Relat Res. 2021 Apr 1;479(4):651-663. doi: 10.1097/CORR.0000000000001605. PMID: 33394605; PMCID: PMC8083833.

  15. Thoomes, E. J., van Geest, S., van der Windt, D. A., Falla, D., Verhagen, A. P., Koes, B. W., … Vleggeert-Lankamp, C. L. (2018). Value of physical tests in diagnosing cervical radiculopathy: a systematic review. The Spine Journal, 18(1), 179–189.

  16. Kang KC, Lee HS, Lee JH. Cervical Radiculopathy Focus on Characteristics and Differential Diagnosis. Asian Spine J. 2020 Dec;14(6):921-930. doi: 10.31616/asj.2020.0647. Epub 2020 Dec 22. PMID: 33373515; PMCID: PMC7788378.

  17. Dydyk AM, Khan MZ, Singh P. Radicular Back Pain. [Updated 2022 Oct 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546593/

  18. Kuijper B, Tans JT, Beelen A, Nollet F, de Visser M. Cervical collar or physiotherapy versus wait and see policy for recent onset cervical radiculopathy: randomised trial. BMJ. 2009 Oct 7;339:b3883. doi: 10.1136/bmj.b3883. PMID: 19812130; PMCID: PMC2758937.

  19. Engquist, M., Löfgren, H., Öberg, B., Holtz, A., Peolsson, A., Söderlund, A., … Lind, B. (2013). Surgery Versus Nonsurgical Treatment of Cervical Radiculopathy. Spine, 38(20), 1715–1722.

  20. Engquist M, Löfgren H, Öberg B, Holtz A, Peolsson A, Söderlund A, Vavruch L, Lind B. A 5- to 8-year randomized study on the treatment of cervical radiculopathy: anterior cervical decompression and fusion plus physiotherapy versus physiotherapy alone. J Neurosurg Spine. 2017 Jan;26(1):19-27. doi: 10.3171/2016.6.SPINE151427. Epub 2016 Aug 26. PMID: 27564856.

  21. Liang L, Feng M, Cui X, Zhou S, Yin X, Wang X, Yang M, Liu C, Xie R, Zhu L, Yu J, Wei X. The effect of exercise on cervical radiculopathy: A systematic review and meta-analysis. Medicine (Baltimore). 2019 Nov;98(45):e17733. doi: 10.1097/MD.0000000000017733. PMID: 31702624; PMCID: PMC6855577.

  22. Dedering Å, Peolsson A, Cleland JA, Halvorsen M, Svensson MA, Kierkegaard M. The Effects of Neck-Specific Training Versus Prescribed Physical Activity on Pain and Disability in Patients With Cervical Radiculopathy: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2018 Dec;99(12):2447-2456. doi: 10.1016/j.apmr.2018.06.008. Epub 2018 Jul 4. PMID: 30473018.

  23. https://liu.diva-portal.org/smash/record.jsf?pid=diva2%3A785214&dswid=2536

  24. Rafiq S, Zafar H, Gillani SA, Waqas MS, Zia A, Liaqat S, Rafiq Y. Comparison of neural mobilization and conservative treatment on pain, range of motion, and disability in cervical radiculopathy: A randomized controlled trial. PLoS One. 2022 Dec 6;17(12):e0278177. doi: 10.1371/journal.pone.0278177. PMID: 36472990; PMCID: PMC9725158.

  25. Thoomes EJ, Scholten-Peeters W, Koes B, Falla D, Verhagen AP. The effectiveness of conservative treatment for patients with cervical radiculopathy: a systematic review. Clin J Pain. 2013 Dec;29(12):1073-86. doi: 10.1097/AJP.0b013e31828441fb. PMID: 23446070.

  26. Young IA, Michener LA, Cleland JA, Aguilera AJ, Snyder AR. Manual therapy, exercise, and traction for patients with cervical radiculopathy: a randomized clinical trial. Phys Ther. 2009 Jul;89(7):632-42. doi: 10.2522/ptj.20080283. Epub 2009 May 21. Erratum in: Phys Ther. 2009 Nov;89(11):1254-5. Erratum in: Phys Ther. 2010 May;90(5):825. PMID: 19465371.

  27. Fritz JM, Thackeray A, Brennan GP, Childs JD. Exercise only, exercise with mechanical traction, or exercise with over-door traction for patients with cervical radiculopathy, with or without consideration of status on a previously described subgrouping rule: a randomized clinical trial. J Orthop Sports Phys Ther. 2014 Feb;44(2):45-57. doi: 10.2519/jospt.2014.5065. Epub 2014 Jan 9. PMID: 24405257.

  28. Romeo A, Vanti C, Boldrini V, Ruggeri M, Guccione AA, Pillastrini P, Bertozzi L. Cervical Radiculopathy: Effectiveness of Adding Traction to Physical Therapy-A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Phys Ther. 2018 Apr 1;98(4):231-242. doi: 10.1093/physth/pzy001. Erratum in: Phys Ther. 2018 Aug 1;98(8):727. PMID: 29315428.

  29. Borrella-Andrés S, Marqués-García I, Lucha-López MO, Fanlo-Mazas P, Hernández-Secorún M, Pérez-Bellmunt A, Tricás-Moreno JM, Hidalgo-García C. Manual Therapy as a Management of Cervical Radiculopathy: A Systematic Review. Biomed Res Int. 2021 Jun 3;2021:9936981. doi: 10.1155/2021/9936981. PMID: 34189141; PMCID: PMC8195637.

  30. Ghasemi M, Masaeli A, Rezvani M, Shaygannejad V, Golabchi K, Norouzi R. Oral prednisolone in the treatment of cervical radiculopathy: a randomized placebo controlled trial. J Res Med Sci. 2013;18(suppl 1):S43-S46.

  31. Gao QY, Wei FL, Zhu KL, Zhou CP, Zhang H, Cui WX, Li T, Qian JX, Hao DJ. Clinical Efficacy and Safety of Surgical Treatments in Patients With Pure Cervical Radiculopathy. Front Public Health. 2022 Jul 14;10:892042. doi: 10.3389/fpubh.2022.892042. PMID: 35910906; PMCID: PMC9330161.

  32. Kleimeyer JP, Koltsov JCB, Smuck MW, Wood KB, Cheng I, Hu SS. Cervical epidural steroid injections: incidence and determinants of subsequent surgery. Spine J. 2020 Nov;20(11):1729-1736. doi: 10.1016/j.spinee.2020.06.012. Epub 2020 Jun 19. PMID: 32565316.

  33. Dydyk AM, Khan MZ, Singh P. Radicular Back Pain. [Updated 2022 Oct 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546593/

Images:

  1. Disc - source: https://commons.wikimedia.org/wiki/File:716_Intervertebral_Disk.jpg attribution: OpenStax College, CC BY 3.0 <https://creativecommons.org/licenses/by/3.0>, via Wikimedia Commons

  2. Split vertebrae - source: https://commons.wikimedia.org/wiki/File:Functional_spinal_unit_(FSU).webp attribution: Irina Nefedova, CC BY 4.0 <https://creativecommons.org/licenses/by/4.0>, via Wikimedia Commons

  3. Dermatomes - source: https://commons.wikimedia.org/wiki/File:Dermatoms_ja.svg attribution: Ralf Stephan (mailto:[email protected]), CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons edited by Fitness Pain Free LLC