Evidence-Based Non-Surgical Strategies for Managing Cervical Radiculopathy
“12 Weeks to Better Posture ™ is the best posture program, if everyone did it I would be out of a job” states Giovanni, a medical doctor who sought postural correction treatment for neck pain, tension headaches and cervical radiculopathy.
The pain and tingling in Giovanni’s arm was interfering with his ability to perform surgery at work. Desperate to correct the problem Giovanni came to the American Posture Institute.
Forward Head Posture and Cervical Radiculopathy:
Postural distortion patterns of the Posture System lead to varying physiologic health consequences. When patients present with forward head posture, a misalignment of the positioning of posture quadrant 1 in relation to posture quadrant 2 is revealed. These patients commonly present with cervical spinal lesions of posture quadrant 1, which often result in symptoms of radiculopathy in the upper extremity of posture quadrant 2.
Research demonstrates that there is a direct correlation between reduction of the craniovertebral angle and increase of neck pain and disability. Patients who present with a smaller craniovertebral angle have a greater degree of forward head posture, causing more pressure to the cervical nerve roots, resulting in a greater level of neck pain disability (Ho Ting Yip et al., 2005).
Forward head posture increases the amount of pressure on the anatomy of the cervical spine. According to Caillet and Gross (1987) forward head posture can add up to 30 pounds of abnormal leverage on the spine. To compensate for this additional pressure, the paravertebral musculature at the base of the neck becomes hypertonically contracted. Patients often associate the muscle tightness at the base of the neck with a stress related onset.
Non-surgical Treatment of Cervical Radiculopathy:
Forward head posture is a contributing factor of painful cervical radiculopathy. To manage symptoms associated with cervical radiculopathy, non-surgical treatment plans to correct forward head posture are considered clinically effective.
Non-surgical treatment plans include spinal manipulation and active and passive postural rehabilitation. According to Murphy et al. (2005), patients who underwent a non-surgical treatment protocol for relief of cervical radiculopathy had a 92.6% clinically significant improvement from baseline to long-term follow-up.
Moustaffa et al. (2011) stated that exercise programs to correct forward head posture are effective in reducing pain associated with cervical spine radiculopathy. Exercises that were found to be the most effective for pain management of cervical radiculopathy include neck retraction exercises. Neck retraction exercises contribute to correction of forward head posture and promote cervical root decompression (Lentell et al., 2002). The reverse is also true. If forward head posture is not corrected, exacerbation of radicular symptoms is expected.
In addition to neck retraction exercises, cervical distraction also contributes to correction of forward head posture and a reduction of symptoms associated with cervical radiculopathy. A multifaceted non-surgical approach is recommended for complete postural correction of posture quadrant 1 to reduce pain of the upper extremity caused by cervical radiculopathy.
When working with patients like Giovanni, it is important to monitor progress throughout their treatment plan to determine objective postural correction outcomes. All postural correction programs are specific to the patient’s individual needs.
