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  • By Dr Ranen Rambrij MTech (Chiro)

    A 54 year old male presented with neck pain radiating to the right scapular and numbness in the fingers of his right hand of 7 weeks duration. Neck pain and subsequent scapular pain and was worse when lifting his head up and down.

    The neurologic examination was normal however the orthopedic examination indicated that his pain was of a radicular origin (compression of the nerve root as it exits the spinal cord on the right side of the neck). 

    Review of a Cervical MRI conducted one month prior found degenerative changes at C5/6 and C6/7 causing narrowing of the Intervertebral foramina (IVF).

    Diagnosis: Right Cervical Radiculopathy

    A cervical radiculopathy is a medical diagnosis which describes compression of a cervical nerve root as it exits the spinal cord on either side of the neck. The compression can be caused by osteophytes (bone spurs) which occur as a result of degenerative (natural aging of the body) changes or by an injury to the disc which compresses the nerve in the IVF (a space through which the nerve roots pass when exiting the spinal cord). 

    The image above shows compression of the nerve root in the IVF by 1) osteophytic formation and 2) Disc injury. 

    Treatment included upper thoracic manipulation, cervical manipulation, flexion distraction of the neck and perineural intramuscular electro stimulation to promote deep muscular activity (small muscles located near the spine and playing a major role in neck stability)

    Following 3 sessions over 3 weeks of the above management protocol the patient noted no neck pain, right sided scapular pain or numbness in the right hand.