Non Operative Management:
The initial management of this condition can include painkillers, muscle relaxants and anti-inflammatory medication. Gentle physiotherapy comprising traction and deep tissue massage may help ease muscle spasm which can occur at the same time. However aggressive manipulation or mobilisation of the neck should be avoided.
Early interventions include radiologically guided injections (cervical rhizolysis) around the nerve roots which can ease the symptoms within a week or two of receiving the injection. This procedure is typically undertaken under x-ray or CT guidance and allows a needle to be placed in close proximity to the nerves exiting the spine.
The doctor will have determined prior to the injection which nerve is being targeted on the basis of the patient’s history, clinical findings on examination and imaging studies. Typically a small volume to steroid is injected around the nerve and between 60 – 70% of patients will notice an improvement in their symptoms within two to three weeks of the injection.
Surgery for cervical radiculopathy can be undertaken using a surgical approach on the front (anterior) or the back (posterior) of the neck. The decision to proceed using either an anterior or posterior approach is based on where the nerve compression is the most severe and the patient’s anatomy.