Cervical radiculopathy (CR) is reported to affect about 3.5 persons per 1000. The condition mostly affects those who are in their 50s and 60s and it does not seem to be gender specific. CR is not typically the result of trauma, rather it is most commonly caused by a cervical disc herniation or a combination of discogenic and spondylotic changes that have become aggravated.
Common symptoms of CR include neck and radicular pain as well as paresthesia. Scapular pain is also common and was present in 51.6% of cases in one study (1).
Physical examination findings typically include painful cervical spine range of motion (ROM) and decreased deep tendon reflexes. Other findings include muscle weakness in 15% of cases, decreased sensation in 1/3 of cases, and rarely muscle atrophy, which is present in less than 2% of cases.
The C7 nerve root is the most commonly involved level, which was present in 39.3%-46.3% of patients in one study; followed by C6 in 17.6%-42.6% of cases (2).
An extensive review of the literature found insufficient evidence to draw firm conclusions about which treatments are appropriate for CR, nor could they identify therapies that are contraindicated (3). Another review reported that the evidence for manipulative therapy in CR is minimal, low in quality and has a high risk of bias (4). Nonetheless, 93% of chiropractors reported that they would use spinal manipulative therapy (SMT) in a patient with suspected or confirmed cervical disc herniation (4). Other manual medicine professionals employ this treatment as well.