Pinched nerve in the neck (cervical radiculopathy)

Why does pain and tingling run down my arm from my neck?

Arm pain, pins and needles or weakness from an irritated nerve root in the neck. Many people improve with conservative care.

What it feels like

Pain that travels from the neck into the shoulder blade, arm or hand, often with pins and needles or numbness in part of the hand, and sometimes weakness in the arm. Looking up or turning the head towards the painful side can make it worse.

What is actually happening

A nerve root in the neck is irritated where it leaves the spine, usually by a disc bulge or by age-related narrowing around the nerve. Many people improve over time with conservative care.

When to see a doctor urgently

See a doctor urgently if you have weakness that is getting worse, symptoms in both arms, clumsy hands or difficulty with buttons and writing, problems with balance or walking, or any change in bladder or bowel control. These can be signs of pressure on the spinal cord.

How it is assessed

Assessment includes the pattern of arm symptoms, a neurological examination of strength, reflexes and sensation, and clinical tests that load or unload the nerve root. The neurological findings are monitored over time.

How it is treated

The Neck Pain clinical practice guideline recommends combining exercise with manual therapy for neck pain with arm symptoms, and mechanical traction may be added as part of that package. A systematic review found no single conservative treatment clearly better than the others, and that many people improve over time, so treatment is matched to your symptoms and how they respond. Treatment includes positions that ease arm symptoms, neck and shoulder blade exercise, nerve mobility work, and adjusting work and sleep positions. If symptoms are severe or weakness is progressing, I write to your family doctor, who can arrange a surgical opinion if it is needed.

What to do first

Find positions that ease the arm symptoms, such as supporting the arm or resting the hand on your head, keep moving gently, and have it assessed, especially if you notice weakness.

Where this is assessed

Athlete's Care Sports Medicine Centres Yonge & Eglinton · Mon/Wed/Fri · 8:00 AM – 2:00 PM Book at Athlete's Care
Push Pounds Sports Medicine Downtown Toronto · Tue/Thu · 8:30 AM – 6:30 PM Call Push Pounds to book
Country Lane Physio Home office & virtual · Sat · By appointment only Message me to book

References

This page is based on the following clinical practice guidelines and research.

Written by Roman Izquierdo, PT, MSc PT, BSc Kin, registered with the College of Physiotherapists of Ontario. General information only, and not a substitute for individual assessment.