Is Important to highlight that the nerves described in all neck neuropathies may be also comprised and entrapped  at the level of the arm region,  hence the shoulder, elbow and hand evaluation and treatment should be incorporated when dealing with patients with cervical  neurological complaint. 

Radiculopathies are generally accompanying with severe linear pain along the path of the compromised nerve in question (media, radial, etc…)  Patients usually reports pain from the neck down into the upper extremity associated with pins and needles, numbness, and weakness in the arm. Increase contraction and intermittent neck and scapulothoracic muscles spams may also develop.

Cervical Nneuropathies and the corresponding symptoms  

C5 radiculopathy causes pain at the side of the upper arm and weakness in arm abduction and elbow flexion.

C6 radiculopathy causes pain at the lateral side of the forearm and first two fingers and weakness on elbow flexion and wrist extension.

C7 radiculopathy causes pain in the middle finger and weakness on arm extension, wrist flexion and finger extension.

C8 radiculopathy causes pain on the lateral forearm and last two finger and weakness on finger flexors

T1 radiculopathy causes pain on the inner part of the arm and weakness in the hand.

Complex regional pain syndrome (CRPS) is a chronic (lasting greater than six months) pain condition that most often affects one limb (arm, leg, hand, or foot) usually after an injury. CRPS is believed to be caused by damage to, or malfunction of the sympathetic nervous system.

Chronic injuries as seen in spinal degeneration may also narrow the nerve passage due to the scar/fibrotic tissue at the superficial fascia and by the osteophytic bone formation from the underlying bones.

Assessment

Neurological examination.

Spinal clinical assessment to identify the dysfunctional vertebral segments that contributed to the level of the radiculopathy.

X-ray analyses

Anteroposterior (AP) and Lateral spinal views are essential to accurately diagnosed and visualise the patterns of misalignment dysfunction responsible for compromising the never root.

MRI analysis

Important exam to verify the level of narrowing of the nerve passage and the exact point of irritation

Rule out any other condition; There are rare disorders that may create similar patterns of dysfunction, is advisable to rule out these conditions prior to the start of the treatment.

Treatment protocol

Specific spinal adjustment to relief the nerve root irritation

Low level laser application from the neck following the path of the  never down the arm

Neuromobilization techniques is used once the direct compression of the nerve is reduced.

Specific therapeutic essential oils are applied to reduce nerve inflammation and enhance healing.

Depending on the level of nerve compromised and chronicity of the misalignment a minimum of 6 weeks up to 12 weeks of treatment care may be necessary to resolve this deformity.