Cervical Radiculopathy

Question on a patient with Cervical Radiculopathy

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Scenario: A 57-year-old male presents with reports of left-sided neck, shoulder, and arm pain persisting for the past eight months. He does not recall a specific injury and reports a gradual onset of pain. Symptoms are described as aching with burning and numbness into the arm and hand. He works as a medical billing specialist and reports increased symptoms after sitting at his desk for over an hour and driving his car for extended periods of time. Cervical left side bending and rotation movements increase arm pain and manual distraction provides symptom relief. Significant forward-head posture is noted along with weakness of the bilateral rhomboids, middle trapezius and serratus anterior. Diminished sensation is noted over the left thumb along with weakness of the left wrist extensors.

Question: What medications are most commonly used to treat cervical radiculopathy and it’s symptoms?

A. Corticosteroids and Tylenol

B. Tylenol and opioids

C. NSAIDS and corticosteroids

D. Opioids and NSAIDS

Answer with rationale: C. NSAIDS and corticosteroids. NSAIDS have anti-inflammatory and pain relieving properties to assist with relieving radicular radiating pain and swelling in the cervical spine. Corticosteroids assist with pain in the spine and related radiating pain.

For more information see Chapter 114: Cervical Radiculopathy in The Color Atlas of Physical Therapy

Eric Shamus, DPT, PhD

Professor, Chair of Department of Rehabilitation Sciences, Florida Gulf Coast University