There is a wide range of treatment options available for cervical radiculopathy. The treatment will depend mainly on the underlying cause of the patient's symptoms as well as the severity of symptoms.
Nonsurgical treatments will usually be tried first. If there is no improvement in symptoms after 6 to 12 weeks of treatment, then surgery might be considered.
Cervical radiculopathy nonsurgical treatments could include some combination of the following:
- Rest or activity modification. Oftentimes cervical radiculopathy resolves on its own, especially if the symptoms are minor. Limiting strenuous activities, like sports or lifting heavy objects, or using better posture while sitting or driving might be all that is needed.
- Physical therapy. An exercise and stretching routine might help relieve symptoms. A physical therapist or other certified medical professional can develop a plan that is specific for the patient.
- Ice and/or heat therapy. Applying an ice pack or a heated gel pack to the neck might offer pain relief for some people. For example, applying cold therapy after an activity-related flare-up of pain is often helpful in reducing inflammation and pain.
- Pain management with medication or injections. Various pain blockers and anti-inflammatories are available to reduce symptoms of pain. Over-the-counter (OTC) medications, such as aspirin, acetaminophen, or ibuprofen could likely be tried first. If OTC medications do not provide the patient relief, prescription-strength medications, such as muscle relaxants or opioids, could be prescribed by the doctor on a short-term basis. Another option could be an injection carefully placed with X-ray guidance to deliver medication directly into the cervical spine, such as a cervical epidural steroid injection.
- Manual manipulation. A chiropractor or other qualified health professional can manually adjust the cervical spine with the goal of improving mobility and providing a better healing environment. Sometimes manual manipulation is part of a physical therapy program.
This is not a complete list of treatments for cervical radiculopathy. For instance, some people might also experience relief from treatments such as massage or traction, and certainly many people find optimal relief with a combination of treatments rather than a single approach.
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For example, a cervical epidural steroid injection may provide acute pain relief that is sufficient to allow the patient to make progress with physical therapy for longer term pain relief.
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When Surgery Is Considered
If nonsurgical treatments are not providing pain relief from cervical radiculopathy, or if neurological symptoms of arm or hand numbness and weakness continue to progress, surgery may be considered.
Common surgical options for cervical radiculopathy include:
- Anterior cervical discectomy and fusion. This surgery goes through a small incision in the front of the neck to remove the disc (which may be herniated or damaged) and then fuses that level of the cervical spine to restore normal height to give spinal nerves enough room and ensure the neck stays stable. This is the most common surgery to relieve symptoms of cervical radiculopathy.
- Artificial disc replacement. Instead of doing a fusion, this surgery replaces the problematic disc with an artificial disc. A potential benefit to this procedure is that it aims to maintain mobility at that level of the cervical spine instead of fusing two vertebrae together.
Neck surgery to reduce hand and arm pain/numbness tends to have a high success rate—some estimates in literature put the success rate between 80% and 90%.1 As with any surgery, there are some risks that will first need to be discussed with the surgeon. It is also important to ask about the surgeon’s experience and what to expect for that particular surgery.
- Rhee JM, Yoon T, Riew KD. Cervical radiculopathy. J Am Acad Orthop Surg. 2007; 15(8): 486-94.