Also called: Cervical radiculopathy
Exercise strongly helps
Strength
Stretch
Pain, numbness or weakness running down the arm in a defined band. A nerve root in the neck is compressed by a disc or by narrowing - and the great majority resolve without surgery over months.
How common: Around 85 per 100,000 per year; peaks at 50-54
What it is
Cervical radiculopathy is compression or irritation of a nerve root as it leaves the neck. It produces symptoms in that nerve's specific territory - a band down the arm to particular fingers - which is what distinguishes it from general neck and shoulder ache.
In younger people it is usually a disc herniation; in older people it is more often narrowing of the exit foramen from degenerative change. Either way the natural history is favourable: most cases improve substantially over weeks to months without surgery, and disc material frequently resorbs.
What it feels like
- Pain radiating from the neck into the shoulder blade and down the arm
- Numbness or tingling in specific fingers rather than the whole hand
- Weakness in particular movements - the grip, the biceps, straightening the elbow
- Worse looking up or tilting the head toward the painful side
- Often relieved by placing the hand on top of the head, which is a characteristic sign
What causes it
Most people have more than one of these at once, and they feed each other. Read the
list looking for the two or three that sound like your week rather than for the one
true answer — the ones that describe you are the ones worth acting on.
- Disc herniation
- Disc material presses on and chemically irritates the nerve root. It is the commoner cause in people under fifty and it is the version with the best natural history, since the material is often reabsorbed.
- Foraminal narrowing
- Degenerative change in the discs and facet joints narrows the opening the nerve leaves through. This is the commoner cause over fifty and it is why extension and side flexion toward the painful side make it worse.
- Chemical irritation
- Disc material is inflammatory in itself. This is why a small herniation can produce severe symptoms and why symptoms can improve substantially before any anatomical change.
- Sustained neck postures
- Prolonged extension or side flexion narrows the foramen and provokes symptoms. Occupations involving looking up or holding a head position are associated.
- Age-related degenerative change
- Ubiquitous over fifty and the underlying substrate for the narrowing form. As elsewhere in the spine, the change itself correlates poorly with symptoms.
- Heavy manual work and vibration
- Both are associated with cervical disc problems, probably through cumulative loading of the discs.
- Smoking
- Consistently associated with disc degeneration and with worse outcomes, probably through reduced disc blood supply.
- Trauma
- A neck injury can herniate a disc acutely. Symptoms starting immediately after an injury deserve prompt assessment.
- Fear and avoidance
- As with any radicular pain, avoiding movement produces stiffness and deconditioning that outlast the nerve problem itself.
Who tends to get it
- Adults between forty and sixty, when it peaks
- Anyone with existing degenerative neck change
- Smokers
- People in heavy manual work or exposed to vibration
- Anyone with a previous episode, which recurs in a proportion
What makes it worse, and what settles it
Makes it worse
- Looking up or tilting the head toward the painful side
- Sustained neck extension at work
- Complete rest and avoidance, which stiffens the neck
- Aggressive traction or manipulation during the acute inflammatory phase
- Ignoring progressive weakness, which is the sign that changes the urgency
Settles it
- Postures and movements that relieve the arm symptoms - often chin tuck and gentle flexion, and the hand-on-head position
- Nerve gliding exercises rather than aggressive stretching
- Deep neck flexor and scapular strengthening once the acute phase settles
- Staying as active as symptoms allow
- Massage and manual therapy for symptomatic relief alongside the active work
What actually helps
The short version: Nerve root compression from disc herniation or foraminal narrowing, with arm pain in a dermatomal pattern
Strength work: Neck - deep cervical flexor endurance; Back: Traps: Lower; Back: Rhomboids - once acute pain settles; Neck: Deep Neck Flexors
Stretching: Neck gently; Chest
Massage: Neck & Shoulders; Back: Upper Back
Also worth doing: Nerve glides; cervical traction has moderate evidence; avoid end-range extension and rotation
What the evidence says: Most resolve within 4-6 months with conservative care. Exercise plus traction beats exercise alone in some trials.
The names above are the Targets qFIT tracks —
the Muscle Guide explains what each one does, and
Quick Add switches on the Exercises you
already have.
The qFIT routine for this
Ready-made routineNeck Relief & Range
qFIT already has this one built. It runs massage first, then stretching, then
strength — the order that works on a body that is already sore — and every
activity in it carries the reason it is there.
The button below opens your Checklist with this routine already selected, so instead
of your whole list you land on just its Categories, Targets
and Exercises, each with its checkbox, ready to tick as you work through
them.
Have more than one problem? Tick yours under My Problems on
My Profile and your Checklist's Routine list gains
Recommended for my problems — every routine for the problems you picked, merged
into one. Your picks stay private; that filter is the only thing they feed.
Get it checked if…
Progressive weakness, clumsy hands, unsteady walking, or bowel and bladder change means cord compression (myelopathy) - urgent surgical referral
And whatever the body part: chest pain or unusual breathlessness on
exertion; a fever alongside the pain; unexplained weight loss; pain that is constant and
unrelated to how you move; new numbness, weakness or loss of bladder or bowel control; or
one calf that is swollen, warm and painful. Any of those, stop and get assessed.
How it usually goes
The great majority improve substantially over six to twelve weeks and continue to improve over months, with a minority needing surgery. Arm pain that reduces and retreats toward the neck is a good sign even if the neck itself hurts more. Progressive weakness, weakness affecting several nerve levels, clumsy hands or unsteady walking suggests cord involvement rather than a single root and needs prompt assessment.
Prevalence basis: Population incidence studies
Others the same routine covers
These share the Neck Relief & Range routine, so the work is the same. If one of them also
sounds like you, that is a reason to expect more from it, not less.
This is general information, not a diagnosis, and it cannot examine you.
If it matches you, use it to ask better questions of a clinician rather than to replace one.