Acute Nerve Root Pain
Acute nerve root pain is referred pain experienced in an area of the arm as a result of a compressed nerve root(an initial segment of nerve leaving the central nervous system eg. spinal cord) in the neck.
This referred pain occurs because each nerve root also supplies sensation to a patch of skin(dermatomes), with the neck nerve roots supplying the face, head and arm. When there is compression of the nerve root the pain is felt in the patch of skin in the arm that particular nerve root supplies.
There are many possible structures that can be indicated, but the most common comes from;
- The irritation of the intervertebral discs that lie between the vertebrae of the neck.
- Compromise of the intervertebral foramen (gaps in between the vertebrae where motor and sensory nerves travel up and down the head, neck and arm back to the spinal cord). This compromise is often due to osteophyte formation(bony spurs associated with osteoarthritis) or inflammation of the nearby structures. As a result of this compressed nerve root the neck muscles commonly go into spasm and themselves are a cause of symptoms.
A common presentation is a patient who has pain following a unnatural prolonged posture.
Due to its degenerative nature, this condition generally affects the older population.
Common symptoms include;
- Moderate to intense pain levels in the head, neck and/or arm. This pain is normally comes on gradually and is aggravated by neck movements, especially movements that close down the intervertebral foramen e.g. extension, side flexion and rotation of the neck.
- Neck pain may or may not feature which makes this condition for the patient hard to understand when it first presents as they often believe they have an arm ache.
- This condition can also feature neurological symptoms due to the nerves being involved. These neurological symptoms can manifest themselves in the form of pins and needles down the arm, parethesia(abnormal skin sensation, burning, prickling, itching and tingling) and muscle weakness.
Due to the highly irritable nature of acute nerve root pain treatment must be gentle and strive to not aggravate the symptoms.
Physiotherapy treatment(see our ethos) consists of;
- You will undergo a comprehensive physiotherapy assessment to determine the cause of the irritation/compression.
- Traction to release compressed nerve roots and relieve pressure of a compromised disc.
- Stretches to restore normal muscle length.
- Massage to relieve tight and spasmed adjacent neck muscles.
- Mobilisation of tight vertebral joints to restore normal movement.
- Posture education to ensure correct neck and upper back function.
- Exercises to maintain movement and strengthen deep postural muscles of the neck.
- Discharge education to manage if these symptoms arise again.