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fascial adhesions, chronic neck pain, and cervical radiculopathy

Radiculopathy refers to a set of conditions in which one or more nerve roots (the nerves along the spine) are affected and do not function properly.  This can result in pain that follows very specific patterns, weakness, numbness, tingling, or difficulty controlling specific muscles.  A nerve root impingement in the neck can produce pain and weakness in the forearm.Cherry picked from a popular online dictionary’s definition of “Radiculopathy”

Arm Pain

CHRONIC NECK PAIN and HEADACHES go together like chicken and dumplings.  But there is another problem that I frequently find in patients struggling with Chronic Neck Pain as well —– various combinations of pain, numbness, tingling and weakness that run into the arm.  This is often times just like SCIATICA, only in the upper extremity instead of the leg.  And just like some cases of Sciatica, there are some cases of Radiculopathy where the neck itself will not hurt even though the arm feels like it is on fire. 

The website of the American Academy of Orthopedic Surgeons says that,

It is most important to note that the majority of patients with cervical radiculopathy get better with time and never need surgery, or even any treatment at all.  It is also not uncommon for cervical radiculopathy to come back at some time in the future, but again, this problem usually gets better without any specific treatment.” 

Unfortunately, they then go on to say that the pain may take months to go away, and frequently returns. 

Frequently returning pain is not my idea of a good time.  Especially if there are things that can be done to prevent it.   The problem is, when the medical community does recommend treatment for cervical radiculopathy, it is almost always in the form of drugs (NARCOTIC PAIN RELIEVERS, Anti-inflammatories, CORTICOSTEROID INJECTIONS, and others).  While this is fine for the short term (very short term), these drugs mask the symptoms without ever really dealing with the underlying cause of those symptoms.  This is probably why the recommendations from the AAOS above —- despite saying that the pain will often go away on its own —- also say that it frequently returns.  Other recommendations are for over-the-door traction (which I strongly suggest in my practice), stretching, strengthening (also good), and even the old “Soft Collars”.  Be warned that the immobilization of a Soft Collar can be a double-edged sword that causes as many problems as it helps (DEGENERATION is just one of the drawbacks of long-term collar usage).  There are even some doctors that actually recommend CHIROPRACTIC for taking care of these types of problems (Dr. Frank Painter comes through with his RADICULOPATHY RESEARCH PAGE). 

There are three main reasons that you will be told that you developed Cervical Radiculopathy.  They are Degenerative Discs, Herniated Discs, and Spinal Stenosis.  Allow me to briefly touch on all three of these.

  • HERNIATED DISCS:  Herniated Discs go by a wide variety of names (Ruptured Discs, Slipped Discs, Disc Bulges, etc, etc).  Think of the Disc as a jelly donut.  It has a jelly-like center (nucleus) that is surrounded by layer after layer of ligaments (the annulus) that hold it in place and keep it from shifting or ‘slipping’.  To read more about the way that Herniated Discs can affect the spinal nerves, CLICK HERE.  Although patients are rarely told this, because of the high incidence of ASYMPTOMATIC DISC HERNIATIONS, it is almost impossible to know if a person’s pain is due to their disc or something else.  Either way you slice it, it is important to realize that many cases of Herniated Discs can be resolved non-surgically with SPINAL DECOMPRESSION THERAPY.
  • DEGENERATIVE DISCS:  The Spinal Discs are the bushings that provide vertical space between the vertebrae.  The thicker the Disc, the more space there is for the nerve to come through the little window known as the IVF (Intervertebral Foramen).  As Discs become degenerative, they get thin.  As Discs get thinner, it makes the IVF smaller and smaller.  HERE is a great explanation of this.  Just remember that this particular problem will always garner the diagnosis of DJD.  This means that your problem will be called ‘age-related’.  Click on the link to see why this is not necessarily true.
  • SPINAL STENOSIS:  Spinal Stenosis is a shrinking of the Spinal Canal (the bony tube that contains the Spinal Cord).  The Spinal Canal has ligaments in it.  These ligaments —- particularly a ligament called Ligamentum Flavum — can, with age, thicken and buckle inward.  When this happens, it causes irritation on the Spinal Cord and nerves.  Go HERE to read more about Spinal Stenosis and how to deal with it non-surgically.

Besides that fact that Chiropractic Adjustments themselves can often help people struggling with radicular symptoms of the upper extremity (see Dr. Painter’s previous link), I find that SCAR TISSUE REMODELING can be quite effective for many people as well.  This is because it is quite common for people who suffer from Radiculopathy to have extremely restricted ranges of motion in their necks (common as in I saw 3 patients with this today — one a 15 year old athlete —- and all of them were either fixed or well on their way).  This loss of motion and restriction can pull, stretch, and subsequently irritate spinal nerves.  When it comes to restoring motion, breaking FASCIAL ADHESIONS, adjusting the restricted areas of the spine, and creating the proper home program for the patient (stretches, exercises, over-the-door traction, an ANTI-INFLAMMATORY DIET, etc) will either resolve or dramatically improve, most cases of Cervical / Upper Extremity Radiculopathy.


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