Cervical Radiculopathy

Phase 1: Acute Phase (Week 1-2)

Goals: Reduce pain and inflammation, avoid aggravation of symptoms, and improve posture.

1. Pain Management:
   • Rest: Avoid activities that exacerbate symptoms (e.g., heavy lifting, prolonged sitting).
   • Heat/Ice: Ice for 10-15 minutes every 2-3 hours for inflammation; heat therapy for muscle tightness.
2. Posture Correction:
   • Postural Awareness: Encourage neutral spine alignment during daily activities.
   • Chin Tucks:
     • How to perform: Sit or stand upright, gently tuck the chin towards the neck without flexing the head forward.
     • Reps: 10-15 repetitions, 3-4 times/day.
3. Isometric Neck Exercises:
   • Neck Flexion/Extension/Side Bends:
     • How to perform: Gently press your hand against the forehead, back of the head, or side of the head, resisting motion for 5-10 seconds.
     • Reps: 5 repetitions in each direction.
4. Cervical Retractions with Scapular Squeezes:
   • How to perform: Perform a chin tuck, followed by pulling the shoulder blades together gently. Hold for 3-5 seconds.
   • Reps: 10-15 repetitions, 2-3 times/day.
5. Gentle Range of Motion (ROM) Exercises:
   • Neck Rotation, Flexion, and Lateral Bending:
     • How to perform: Slowly rotate, bend, or flex the neck within a pain-free range of motion.
     • Reps: 10-15 repetitions, 2-3 times/day.

Phase 2: Subacute Phase (Week 3-6)

Goals: Increase mobility and begin strengthening; maintain postural corrections.

1. Continue with Posture and Pain Management:
   • Chin Tucks and Scapular Squeezes: Continue exercises from Phase 1, but increase hold time to 10 seconds.
   • Modalities: Ice/heat as needed for pain management.
2. Range of Motion (ROM) Exercises:
   • Progress ROM: Increase range of motion by incorporating side-to-side rotation and extension while seated with support.
   • Reps: 2 sets of 10 repetitions, 3 times/day.
3. Stretching:
   • Upper Trapezius and Levator Scapulae Stretch:
     • How to perform: Sit upright, tilt your head to one side, and gently pull with the opposite hand for a deeper stretch.
     • Reps: 20-30 seconds hold, 3-5 repetitions each side.
4. Strengthening Exercises:
   • Resisted Isometrics:
     • How to perform: Use a resistance band or manual resistance to gently resist neck flexion, extension, lateral bending, and rotation.
     • Reps: 10 repetitions, 2 sets/day.
5. Scapular Strengthening:
   • Rows with Resistance Band:
     • How to perform: While seated or standing, pull a resistance band towards your chest, squeezing the shoulder blades together.
     • Reps: 2 sets of 10-15 repetitions.

Phase 3: Strengthening and Conditioning (Week 6-12)

Goals: Restore full strength, stability, and prevent recurrence.

1. Strengthening Progression:
   • Continue Chin Tucks with Resistance: Use a resistance band for cervical flexion/extension.
   • Reps: 2 sets of 15-20 repetitions.
2. Core Strengthening:
   • Planks: Begin with forearm planks for 10-20 seconds, gradually increasing the hold time.
   • Reps: 3 sets.
3. Postural Strengthening:
   • Scapular Stability Exercises:
     • Wall Angels: Stand with your back against a wall and slowly raise your arms overhead, keeping them in contact with the wall.
     • Reps: 2 sets of 10 repetitions.
4. Functional Exercises:
   • Arm and Neck Coordination Drills: Incorporate light resistance and coordination exercises for daily tasks, like reaching or lifting.

Phase 4: Return to Activity (Week 12 and beyond)

Goals: Return to normal activity, work, or sports with proper body mechanics.

1. Functional Training:
   • Tailor the program to specific work or recreational activities (e.g., for desk workers, ensure proper ergonomic setup and posture awareness).
2. Sport-Specific Training:
   • For athletes, introduce specific neck and upper body exercises to build strength for sports like swimming, tennis, or weightlifting.
3. Maintenance Exercises:
   • Continue core stability and neck strengthening exercises 2-3 times a week to prevent recurrence.

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