Nonoperative Treatment for Cervical Radiculopathy: Finding Relief Without Surgery Is the Norm

Most patients don’t need surgery. Why is that? We can thank the body for its tremendous ability to heal itself. The case of cervical radiculopathy is no different. Cervical radiculopathy refers to neurologic symptoms that occur when a nerve is pinched, or compressed, in a person’s neck. Symptoms can include pain in the neck, shoulder, shoulder blade, arm, and/or hand. Symptoms also may include numbness, tingling, and/or weakness. These symptoms can be scary and alarming compared to typical musculoskeletal pain. Nevertheless, research shows that most people get better over time and never need surgery. While the body is working on healing itself, nonoperative treatments can provide effective relief. Below, we'll explore various nonoperative treatment options available for cervical radiculopathy.

1. Rest and Activity Modification:

Rest is often the first step in managing cervical radiculopathy. Simply put, avoid unnecessary activities that aggravate pain until you feel better if you can help it.

2. Physical Therapy:

Physical therapy (PT) and home exercise programs do help! Physical therapists can design customized exercise programs to help decrease pain and improve neck mobility. Many of my patient’s are skeptical of PT at first and then thank me later. Some of the treatments that these converted PT enthusiasts champion include cervical traction, posture training, and range of motion exercises.

3. Medications:

The goal of medications is to ease pain (within reason). We only prescribe it if patients cannot deal with their pain. Most patients would rather avoid medications. When requested, my go-to medications include a short course of oral steroids, non-steroidal anti-inflammatory drugs (NSAIDs - Ibuprofen, Naproxen, etc), nerve pain medications (gabapentin, maybe cymbalta), and tylenol.

4. Cervical Traction:

Cervical traction involves the gentle stretching of the neck to increase the space between vertebrae. This stretching can mechanically “decompress” a pinched nerve. Cervical traction can be done under the guidance of a physical therapist. There are also commercially available home traction units. Home traction units are generally safe, cost effective and readily available. A number are available on Amazon. Inflatable Neck Traction Pillow

5. Epidural Steroid Injections:

If cervical radiculopathy lasts longer than 3 months, a steroid injection becomes an option. Steroids calm down inflamed tissues. Think hydrocortisone for rashes and steroid inhalers for bad asthma. Steroid in liquid form can be placed around inflamed nerve roots with a needle. These injections provide short-term relief (weeks to months). The injections offer the body more time to try to heal itself.

6. Heat and Cold Therapy:

Applying heat or cold packs to a painful area in the body can help some patients. Heat is particularly helpful for tense muscles.

7. Lifestyle Modifications:

Making certain lifestyle changes can aid in the recovery process. Maintaining a healthy weight, avoiding smoking, and practicing good posture can all contribute to better outcomes.

8. Alternative Therapies:

Some individuals find relief through complementary therapies like acupuncture, chiropractic care, or massage therapy. While these approaches may not work for everyone, they are worth considering in consultation with your healthcare provider.

Conclusion:

Nonoperative treatments for cervical radiculopathy offer a range of options to alleviate pain and improve function. The choice of treatment depends on patient preference and the recommendations of your healthcare provider. While surgery may be necessary in some cases (10% or less), nonoperative treatments work well for the vast majority of patients. Always consult with a medical professional to determine the most suitable treatment plan for your specific condition.

Best regards,

Dr. B

Orthopedic Spine and Joint Surgeon

𝗡𝗼 𝗰𝗼𝗻𝘁𝗲𝗻𝘁 𝗼𝗻 𝘁𝗵𝗶𝘀 𝗽𝗮𝗴𝗲 𝘀𝗵𝗼𝘂𝗹𝗱 𝗲𝘃𝗲𝗿 𝗯𝗲 𝘂𝘀𝗲𝗱 𝗮𝘀 𝗮 𝘀𝘂𝗯𝘀𝘁𝗶𝘁𝘂𝘁𝗲 𝗳𝗼𝗿 𝗱𝗶𝗿𝗲𝗰𝘁 𝗺𝗲𝗱𝗶𝗰𝗮𝗹 𝗮𝗱𝘃𝗶𝗰𝗲 𝗳𝗿𝗼𝗺 𝘆𝗼𝘂𝗿 𝗱𝗼𝗰𝘁𝗼𝗿 𝗼𝗿 𝗼𝘁𝗵𝗲𝗿 𝗾𝘂𝗮𝗹𝗶𝗳𝗶𝗲𝗱 𝗰𝗹𝗶𝗻𝗶𝗰𝗶𝗮𝗻.

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