How is it diagnosed?
When you seek the help for a pinched nerve, the clinician will perform a comprehensive evaluation and ask questions about your pain and your daily activities. These may include:
- How and when the pain started: Did the pain begin spontaneously or was there any trauma or popping experienced in the cervical region?
- Where are the symptoms located, and have they changed location or intensity since the onset?
- What makes the symptoms better or worse?
- What type of work do you perform?
- What hobbies or household activities do you regularly perform?
Your physical therapist will gently test the movement of your neck and arms. The therapist will check your tendon reflexes and strength, and conduct special tests on your neck and upper extremity to determine which spinal nerve root(s) may be involved and to rule out other conditions. To provide a definitive diagnosis, your therapist may collaborate with an orthopedist or other healthcare provider. The orthopedist may order further tests, such as magnetic resonance imaging (MRI) or electromyography (EMG). An MRI can show soft tissues, including the spinal cord and nerve roots. This test can determine what is causing the compression on the nerves, including disc bulges or disc herniation. An EMG measures the nerve and muscle function. This test can tell how well your spinal nerves are communicating to your muscles.
For most common cases, imaging is not needed and the diagnosis can be made with a simple physical evaluation. No need to waste thousands of dollars on un-needed diagnostic imaging. Many of the positive findings found on x-rays, MRI, and EMG may not be the root cause of your pain. What do you mean? Many positive findings on an MRI are also found in asymptomatic (pain-free) individuals, so how do you know if this is causing your pain or not.
How can a Physical Therapist treat it?
Physical therapy is an effective treatment for a pinched nerve and cervical radiculopathy, and in many cases, it completely resolves symptoms. Your physical therapist will develop an individual treatment plan based on the findings of your initial evaluation. The treatment plan may include:
The first goal is to reduce the pain and inflammation in the area. Ice packs applied to the neck and scapular (shoulder blade) region during the first 24 to 48 hours following the onset of pain, help reduce inflammation. Moist heat such as a hot towel can be used after this time period to help the surrounding muscles relax. Your physical therapist may advise you to wear a soft cervical collar at times throughout the day, to allow the neck to relax. A cervical contoured pillow may be recommended to properly support the neck, and allow you to sleep more comfortably.
Your physical therapist may use manual therapy techniques, such as manual cervical traction, to relieve pressure in the cervical (neck) region. This procedure can provide immediate relief of pain and numbness radiating into the arm. Gentle massage may also be performed on the muscles of the cervical spine and scapular (shoulder blade) region. This technique helps the muscles relax and improves circulation to the area, promoting healing and pain relief.
Posture education is an important part of rehabilitation. Your physical therapist may suggest adjustments to your workstation and work habits to promote good posture to protect your neck. In the early stages of recovery this may mean sitting only 15 to 20 minutes at a time. You will also receive instructions on how to bend, reach, and lift throughout the day in safe positions that place minimal pressure on your spinal discs.
Your physical therapist will teach you gentle cervical mobility exercises to relieve your symptoms, and allow you to return to normal movement. In the beginning stages of recovery, it is important that none of these exercises increase the pain radiating down into your arm. It is important to communicate your symptoms accurately to your physical therapist. If you spend many hours sitting at a desk during your workday, your neck may become stiff. Your therapist will teach you neck stretches to take pressure off of your neck from extended periods of sitting to help improve your mobility.
Your physical therapist will help you determine which muscle groups need to be strengthened based on which spinal nerves are involved in your particular case. When pain no longer radiates down your arm, you may begin more aggressive strengthening exercises. Neck stability (strengthening) exercises will also be performed. You will receive a home exercise program to continue strengthening your neck, shoulder, arm, and upper back long after your formal physical therapy has ended.
As your symptoms improve, your physical therapist will work on functional exercises to help you return to your job, sport, or other daily activities. For example, if your job duties require overhead reaching, pushing, pulling, and long periods of sitting, you will be taught ways to perform these tasks to reduce undue stress to the neck.
“After at least three years of doctor-hopping […] looking for someone to alleviate my constant dizziness and neck pain, I finally found Dr. Miller. I have more energy and less pain, and have halved my dependence on painkillers. He shouldn’t be the last stop on your road to recovery, he should be the first.”
How long does it take for a recovery?
Recovery time for a pinched nerve in the neck depends on multiple factors: the severity of your pinched nerve, how long you have been in pain for, the medical professional you choose, and how active you are in trying to resolve your pain.
If you do nothing, acute cases may or may not resolve in 4-8 weeks spontaneously.
If you get expert treatment, some cases resolve in 1-3 weeks and get you back to the sport, exercise, and your favorite activities without flare-ups and recurrences.
If it is a complex case of chronic pain, this may take longer, but you can still get a good outcome. Some chronic cases can resolve as fast as 2 months and as long as 4-6 months. It varies with every patient because every case of neck pain or a pinched nerve is different.
How much does it cost?
The average cost of care for a case of spine pain in the US is $1800-$6600. This high price is thanks to the often inefficient and cumbersome approach to getting treated, often requiring multiple visits to different doctors and physical therapists until you get settled in and start treatment. We strive to end that unnecessary, expensive cycle. In fact, we are currently publishing our first-year data with the University of Central Florida that shows the cost-effectiveness of our treatment approach. The average cost of our care was shown to be $814. So if you have a deductible of $3000-$8,000, we can save you lots of money.
Remember, every case of neck pain is different and not all neck pain is the same. So it is hard to predict and tell you how much your neck pain is going to cost you. But after a thorough evaluation, we can tell you exactly what is causing your neck pain, how long it is going to take, what is the best way to treat it, and exactly how much it is going to cost. We have no hidden fees, no co-pays, and no miscellaneous bills that you surprisingly receive 3 months later after you receive treatment. Your pain, your diagnosis, your goals, and what is best for you dictates your treatment and how much it will cost. It varies for every patient but it is still way cheaper than standard healthcare.
How long are sessions?
Our evaluations are 60-90 minutes long. We like to perform thorough evaluations so we can solve the root cause of your pain, identify all risk factors, and make sure that we do it right. After the evaluation, you will know your diagnosis, the root cause of why you have your pain and symptoms, your prognosis, an expected timeline of when you should see results, what the best way to treat your pain is, how much it will cost, and your expected recovery. We will have plenty of time for you to ask questions and make sure you fully understand why you have your pain and what is the best way to treat it. After the evaluation is completed, all treatment sessions are 60 minutes going forward and you and your physical therapist will design a customized treatment plan that works for you and that will achieve your goals.
How can it be prevented?
Your physical therapist will educate you on the best ways to prevent cervical radiculopathy from recurring, including:
- Maintaining proper posture. Use a supportive pillow and proper posture when sitting at a desk or in the car.
- Setting up your workstation to minimize undue forces on the spine. You may be advised to use a hands-free phone or adjust your computer monitor to avoid excessive twisting or extending of your neck in repetitive directions during the workday.
- Continuing with regular exercise to maintain spinal muscles flexibility and strength, including the upper body, middle back, and core muscles.
- Keeping a healthy weight to minimize unnecessary forces on the spine.
What are next steps?
If you’re ready to get pain free, give us a call at (407) 494-8835 or fill out the form below. We’re happy to answer any questions and get you back to doing what you love.