Physical Therapy Exercises for Cervical Radiculopathy Unilateral Weakness

Cervical radiculopathy physical therapy exercises may give your neck more stability and promote proper posture. Those who have cervical pain with arm numbness and weakness typically respond well to conservative treatment that includes exercises and medication.

Cervical radiculopathy occurs when a nerve in the neck is pinched or irritated, causing pain, numbness and muscle weakness in the arm and hand. The good news is that this condition often responds well to conservative treatment, which includes exercises and medication, states the American Academy of Orthopaedic Surgeons (AAOS).

In older people, cervical radiculopathy is often caused by degenerative changes in the cervical disks. These changes result in the disks drying out over time, losing height and compressing the nerves in your neck, causing the symptoms. These types of degenerative changes may lead to arthritis or spondylosis in the long run.

Younger people who are experiencing cervical radiculopathy symptoms often have a disk herniation, says the AAOS. This often occurs during an acute injury caused by lifting, pulling, bending or twisting. When the jelly-like center of the disk bulges out, it compresses the nerve root, leading to pain and weakness.

The symptoms of cervical radiculopathy include a sharp, burning pain that starts in the neck and travels down the arm. They are often present in one arm, not both. You may also experience tingling and numbness, as well as weakness in the arm, shoulder or hand, according to the AAOS.

Pain often increases with straining the neck or turning the head. Some people experience a reduction in pain when placing their hands on top of the head, as this relieves pressure on the nerve root. Muscle weakness may also result from the cervical nerve being compressed. Depending on where the nerve is compressed, you will have muscle weakness in different areas, says Washington University.

For example, if your C5 cervical nerve is being compressed, you will have muscle weakness in your deltoid muscle. The C6 nerve will result in weakness in your biceps, along with wrist extension. The C7 nerve affects your triceps muscle and wrist flexion, while C8 affects your finger flexors. Your doctor or physical therapist will check your muscle strength of each arm to determine which cervical nerve is being affected.

The majority of people will recover from this condition with conservative treatment including anti-inflammatories, soft cervical collars and physical therapy.

Cervical collars allow the muscles in your neck to rest and may help reduce pinching of the nerves. However, they should only be worn for a short time. Long-term wear may cause the muscles in your neck to become weak, notes the AAOS.

Cervical radiculopathy physical therapy exercises may be effective in treating this condition, reports a May 2016 review in American Family Physician. Researchers recommend both physical therapy and home exercise programs at least twice a week.

The following cervical radiculopathy stretches are recommended by the University of Wisconsin. Check with your doctor before starting an exercise program. Stop any activity that increases the pain.

Move 1: Side Stretch

1. Relax your shoulders and tilt your head toward one shoulder.
2. Hold for 15 to 30 seconds.
3. Repeat on the other side.
4. For more of a stretch, use your hand to gently pull your head down toward your shoulder.
5. Repeat two to four times on each side.

Move 2: Diagonal Stretch

1. Turn your head diagonally toward your chest.
2. Hold for 15 to 30 seconds.
3. Use your hand to gently and steadily pull your head forward.
4. Repeat two to four times on each side.

Move 3: Chin Tuck

1. Sit or stand tall and look straight ahead.
2. Tuck your chin back as you feel your head glide backward.
3. Hold for a count of six. Relax for 10 seconds.
4. Repeat eight to 12 times.

Move 4: Chest and Shoulder Stretch

1. Stand tall and tuck your chin in.
2. Raise both arms so they are next to your ears.
3. Lower your elbows down and behind your back. You will feel your shoulder blades come together, as well as a stretch in your chest and front of shoulders.
4. Hold for six seconds and relax for 10 seconds.
5. Repeat eight to 12 times.

Read more: Neck Stretches to Remove Knots

The following cervical radiculopathy treatment exercises will strengthen your neck, upper back and core. This will give your neck more stability and promote proper posture to prevent future cervical injuries, says Harvard Health Publishing. It is important to perform cervical radiculopathy stretches along with strengthening exercises.

Perform the following movements as recommended by the NASS and the Physical Therapy and Sports Medicine Institute. Stop if your symptoms get worse.

Move 1: Isometric Strengthening

1. Sit in a chair and start with your head in a neutral position.
2. Place your hand across your forehead.
3. Push your head and neck forward, as hard as you are able, while your hand resists the movement.
4. Push for 10 seconds. Relax. Repeat three times.
5. Repeat with your hand against the back of your head, and on each side of your head.

Move 2: Prone Head Lifts

1. Lie face down on a mat and prop up on your shoulders.
2. Let your head hang down all the way so your chin is near your chest.
3. Lift your head upward to the neutral position as you tuck your chin.
4. Continue lifting your head as you attempt to look up at the sky.
5. Hold for five seconds. Return down to the head-hanging position.
6. Repeat five times, two times a day.

Move 3: Supine Head Lifts

1. Lie on your back on a mat.
2. Raise your head completely off of the mat, taking your chin to your chest.
3. Hold for five seconds. Return to resting position. Repeat eight to 10 times, twice a day.

Move 4: Scapular Retraction

1. Stand with your arms at your sides, with your head and neck in a neutral position.
2. Pull both shoulders back, while squeezing your shoulder blades backward and downward.
3. Hold for 10 seconds, working up to 30 seconds.
4. Perform five times, twice a day.
5. Work up to adding a resistance band or rows at the gym.

Move 5: Shrug

1. Stand facing a mirror with your shoulders back and chin in a neutral position.
2. Hold a dumbbell in your hands, with your arms at your sides.
3. Start with a three-pound weight, progressing to a five-pound and then a 10-pound weight.
4. Keeping your arms straight, move your shoulders up toward your ears.
5. Pause at the top, then move your shoulders back and down.
6. Perform two sets of 15 reps.

Read more: Foam Roller Exercises for the Neck

In addition to cervical radiculopathy physical therapy exercises, traction can provide relief to those with this condition, says the AAOS. Steroid injections can also be used to decrease inflammation. Surgery is typically performed on those who don't respond to conservative treatment. Some people will notice an improvement in pain in just days or weeks, but for others, it may take longer for the pain to subside.