Neck & Shoulder

What It Is

Some people suffer with neck pain that spreads (radiates) down into the shoulder and the arm, sometimes with muscle weakness and numbness. Most of the time, this is caused by a nerve in the neck being squeezed or irritated where it branches away from the spinal cord (American Academy of Orthopaedic Surgeons, n.d.). This type of injury is often called a pinched nerve (radiculopathy). But it can also be called a trapped nerve.

Cervical radiculopathy is often caused by age-related wear and tear of the discs in the neck (disc degeneration) or by a herniated disc. In a herniated disc, the soft, jelly-like centre of the disc pushes out through its tough outer ring. In younger people, it is most often caused by a sudden injury that results in a herniated disc (American Academy of Orthopaedic Surgeons, n.d.). It is most common in people in their 40s and 50s, and risk factors include smoking and heavy lifting (Iyer and Kim, 2016).

The good news is that most people with cervical radiculopathy get better over time and do not need treatment. For some, the pain goes away in days or weeks; for others it may take longer (American Academy of Orthopaedic Surgeons, n.d.).

Cervical Radiculopathy Anatomy

Numerous important structures are in the neck. The spinal cord, oesophagus (food pipe), trachea (windpipe) and large blood vessels all run through the neck. Seven stacked bones (vertebrae) are within the neck. The column of bones begins underneath the skull and goes all the way to the upper back.

Inside the spinal column, there is a tube for the spinal cord. This thick bundle of nerves begins at the base of the brain. Its job is to carry information between the brain and the body. Nerve roots branch out from the spinal cord through small openings in the sides of the vertebrae (American Academy of Orthopaedic Surgeons, n.d.). The discs are between the vertebrae. They serve as a cushion between the vertebrae in the spine. All of the discs attach to the base of the vertebra above and the top of the one below. Muscles and ligaments hold the column together. All of the structures work together to surround, support and protect the spinal cord.

Most often the trapped nerve is pinched by a disc, but bone spurs (small bony growths that form as the spine ages) can also narrow the openings where the nerve roots leave the spine and pinch a nerve (American Academy of Orthopaedic Surgeons, n.d.).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Cervical Radiculopathy

In physical therapy, specific exercises can help relieve pain, strengthen the neck muscles and improve range of motion, and in some cases traction (gently pulling in line with the spine) can be used to stretch the joints and muscles of the neck (American Academy of Orthopaedic Surgeons, n.d.). I can help with exercises for your neck and arm symptoms, soft tissue massage to ease muscle tension in the neck, and advice on posture and sleeping. See the My Approach tab for how I work.

1. Anti-Inflammatory Medication

The American Academy of Orthopaedic Surgeons (n.d.) says anti-inflammatory medicines, including aspirin, ibuprofen and naproxen, may provide relief if your pain is caused by nerve irritation or inflammation. For neck pain, the NHS suggests paracetamol or ibuprofen, or ibuprofen gel rubbed on the neck (NHS, 2023a). (This medicine information comes from the American Academy of Orthopaedic Surgeons and the NHS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Strong painkillers: prescription painkillers (opioids) are kept for severe pain that other options have not relieved, and are only prescribed for a limited time (American Academy of Orthopaedic Surgeons, n.d.).
Oral corticosteroids: a short course of steroid tablets may help relieve pain by reducing swelling and inflammation around the nerve (American Academy of Orthopaedic Surgeons, n.d.).
Steroid injections: steroid medicine can be injected near the affected nerve. It does not take the pressure off the nerve, but it may lessen the swelling and pain long enough for the nerve to recover (American Academy of Orthopaedic Surgeons, n.d.).
Surgery: if non-surgical treatment has not relieved your symptoms after a period of time, an operation may be recommended (American Academy of Orthopaedic Surgeons, n.d.).

How I can help (see the My Approach tab)

Neck exercises to ease arm symptoms and build strength

Hands-on work for the neck, shoulders and upper back

Gentle manual neck traction, with no sharp or fast movements

Posture, desk set-up and sleeping advice

Tips

Bad posture, such as sitting at a desk for a long time, is one of the most common causes of neck pain in general. Try not to keep your neck in the same position for a long time (NHS, 2023a).
Sleeping awkwardly can also cause neck pain. Use a low, firm pillow, keep your head at the same height as the rest of your body, and avoid sleeping on your front (NHS, 2023a). I can give you further advice about your sleeping position.
Heavy lifting and smoking are risk factors for cervical radiculopathy (Iyer and Kim, 2016).
An injury such as whiplash from a car accident is a common cause of neck pain (NHS, 2023a).
Cervical radiculopathy is most common in middle age, in people in their 40s and 50s (Iyer and Kim, 2016).
Even when cervical radiculopathy comes back at some point in the future, it usually gets better again without any specific treatment (American Academy of Orthopaedic Surgeons, n.d.).

Treatment

My Approach

A pinched nerve in the neck can send pain, pins and needles or numbness into the shoulder and arm. My aim is to ease the pressure on the nerve, settle the muscles around it, and find the movements that calm your arm symptoms.

How I help depends on how severe it is. If you have pain, tingling or numbness but no weakness, I treat it directly. If you have weakness in your arm or hand, numbness that is spreading or getting worse, or problems with walking or co-ordination, please see your family doctor or nurse practitioner first (see When to Get Help); once you've been checked, I provide supportive care alongside their plan.

I start by assessing how your neck moves and which movements bring your arm symptoms on or ease them, and I screen the nerves in your arms (feeling, reflexes and strength), rechecking as we go.

If It's Mild

Neck retraction: gliding your head straight back, like making a double chin, repeated through the day, then adding gentle extension once that's easy
Using your arm as the guide: symptoms easing out of the arm towards the neck is a good sign; symptoms spreading further down means we stop or change what we're doing
Hands-on work for the neck, shoulders and upper back, with gentle, low-velocity mobilisation of the neck and upper back, never quick thrusts
Gentle manual neck traction, with no sharp or fast movements
Gentle nerve glides as your arm settles
Help with your desk set-up and pillow, a home programme, and if you lift, building your training back up gradually

If It's Severe or You've Had Surgery

I work alongside your medical team, and after surgery I need your surgeon's okay before hands-on treatment
Gentle work for the shoulders and upper back, scar work once the wound has healed, and gradual strengthening in step with your team's plan

If weakness gets worse, ask for an urgent appointment. For new problems walking, loss of bladder or bowel control, or a sudden lack of co-ordination, call 911 or go to the emergency room.

What to Expect

Typical Course

Typical course: If it's mild, most people come in once or twice a week at first, then weekly, then less often, with a reassessment at about 4 to 6 weeks; for some the pain goes away in days or weeks, for others it takes longer. If you've needed medical care first, visits follow your doctor's plan, usually weekly, and recovery tends to take longer, especially after surgery.

What I Focus On

Severity Check

Neck Retraction

Neck & Shoulder Release

Nerve Glides

Posture & Desk Set-Up

Please read

When to See a Doctor First

When to Get Help

See your family doctor or nurse practitioner if your pain does not go away after a few weeks, painkillers have not worked, or you have other symptoms like pins and needles or a cold arm (NHS, 2023a). Ask for an urgent appointment with your family doctor or nurse practitioner if you have heaviness or weakness in your arms or legs (NHS, 2023b).

Call 911 or go to the emergency room at your nearest hospital if you have new problems walking, loss of bladder or bowel control, or a sudden lack of co-ordination, for example with tasks like buttoning a shirt (NHS, 2023b).

Sources

References

American Academy of Orthopaedic Surgeons (n.d.) Cervical radiculopathy (pinched nerve). OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/cervical-radiculopathy-pinched-nerve/ (Accessed: 7 October 2026).
Iyer, S. and Kim, H.J. (2016) 'Cervical radiculopathy', Current Reviews in Musculoskeletal Medicine, 9(3), pp. 272–280. doi: 10.1007/s12178-016-9349-4
NHS (2023a) Neck pain. Available at: https://www.nhs.uk/conditions/neck-pain/ (Accessed: 7 October 2026).
NHS (2023b) Cervical spondylosis. Available at: https://www.nhs.uk/conditions/cervical-spondylosis/ (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooCervical Radiculopathy (Pinched Nerve)

What It Is

Cervical Radiculopathy Anatomy

Self-Care & Treatment

How to Treat Cervical Radiculopathy

1. Anti-Inflammatory Medication

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

If It's Mild

If It's Severe or You've Had Surgery

Typical Course

When to See a Doctor First

When to Get Help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooCervical Radiculopathy (Pinched Nerve)

What It Is

Cervical Radiculopathy Anatomy

Self-Care & Treatment

How to Treat Cervical Radiculopathy

1. Anti-Inflammatory Medication

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

If It's Mild

If It's Severe or You've Had Surgery

Typical Course

When to See a Doctor First

When to Get Help

References

Related Conditions

Anterior Scalene Syndrome

Cervical Somatosensory Dysfunction

Costoclavicular Syndrome

Pectoralis Minor Syndrome

Book a session