Physical Therapy for Cervical Radiculopathy: Rehab for a Pinched Nerve (2024)

Physical therapy for cervical radiculopathy can help manage pain, improve the range of motion in your neck, and strengthen your muscles.

Cervical radiculopathy occurs when a spinal nerve in your neck becomes pinched or compressed (commonly referred to as a pinched nerve). This "pinched nerve" can cause pain and weakness, and make normal tasks like sitting, using your arms, or sleeping difficult to do. Most episodes of cervical radiculopathy last for three to six weeks.

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

Symptoms of Cervical Radiculopathy

Symptoms of cervical radiculopathy may include:

• 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

Pinched Nerve Exercises

Most people with cervical radiculopathy work with an orthopedic physical therapist or one who is a musculoskeletal specialist. Your physical therapist may use various treatments to manage your cervical radiculopathy.

Exercise and postural correction should be your main tools in the treatment of your cervical radiculopathy. The 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 keep pressure off the nerve.

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.

Chin Tuck

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.

Traction Exercise

Cervical traction for cervical radiculopathy is a common therapy done in hospitals and other healthcare settings. Research suggests there are benefits to doing home traction exercises too.

You can:

• Lay on your back on the edge of the bed, with your feet toward the center
• Lower your head and upper torso so the head hangs down freely from the bed
• Hold the position for 1 minute

Try this exercise 6 times a day. The study showed that after 3 weeks, it relieved pain and related symptoms.

Neural Flossing

Neural flossing, sometimes called neural gliding, is a technique used to reduce nerve tension and tightness. It is commonly used to treat cervical radiculopathy.

These neck exercises (back, forward) are meant to stretch the affected area to the point of a tingling sensation, with minor pain in some people but only for a few minutes. They're designed to improve flexibility, balance, and range of motion.

Neck Extensions

Exercises to improve neck extension and range of motion are helpful in treating problems with forward head posture, a common condition associated with work stations and your ergonomic environment. Studies find exercise may be more important than getting a new desk.

The National Academy of Sports Medicine recommends exercises to lengthen the neck and thoracic muscles, stretching the neck with the arm extended. Holding the pose for 20 to 30 seconds, up to four times a day. It can be helpful to do this along with other exercises like the self-myofascial release.

Side Tilts

Neck tilts are a great exercise for cervical radiculopathy caused by arthritis or stenosis. To perform this exercise, sit in a chair and slowly tilt your neck to one 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. They may have you tilt your neck as forward as possible, too.

Isometric Holds

Therapy for cervical radiculopathy also may include isometric holds, a type of exercise in which you hold the motion in your neck muscles still. They work on the basis of resistance, for example, holding your neck in a tilt for 30 seconds with your hand pressing against it before releasing the position. You can do so while standing or sitting in a chair.

Isometric holds are targeted on a specific spot, which makes them a good choice if you've had surgery or need to recover from injury. Ask your physical therapist if isometric holds for your shoulders and arms may help with the condition, too.

Shoulder Circles

Shoulder circles 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.

Side to Side Strengthener

To improve overall neck mobility, your therapist may recommend this exercise for cervical rotation. 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.

Summary

Cervical radiculopathy is a condition that causes pain, weakness, numbness and tingling, and loss of mobility in your neck and arm. 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. The exercises for cervical radiculopathy presented here are commonly used, but be sure to discuss them with your therapist before starting an exercise program.

Your healthcare team should be continually assessing your response to treatment. You can expect therapy and recovery to last between three and six weeks, with a return to normal function within a month or two.