Pinched Nerve in the Neck (Cervical Radiculopathy)Adelaide

What a Pinched Nerve in the Neck Looks Like

A pinched nerve in the neck is not the same as general neck pain, and careful assessment matters. Research suggests conservative care combining examination-guided manual therapy, exercise, and neural mobilisation may help many people. Progress is reviewed at each visit, and referral is offered where clinically appropriate.

Typical features include:

• Location of arm pain that follows a specific nerve pathway, often into one or two fingers or a defined forearm region, rather than a diffuse whole-arm ache.
• Altered sensation such as pins-and-needles, numbness, or a burning quality in a dermatomal distribution.
• Aggravators including extending the neck, rotating the head toward the symptomatic side, or sustained postures such as long screen sessions.
• Easing often with offloaded positions, gentle movement, and sometimes placing the hand on top of the head (the shoulder abduction relief sign).
• Differentiation point: nerve-root patterns typically follow a clear dermatomal and myotomal distribution, while general neck pain tends to stay in the neck and upper shoulders without a consistent arm-line.

How We Assess It: History, Neurological Screening, and Provocation Testing

A structured bedside assessment may include dermatomal sensation testing, myotomal strength testing, reflex comparison, and orthopaedic tests such as Spurling, cervical distraction, and the upper-limb tension test. When a cluster of tests is positive, the probability of nerve-root involvement is meaningfully higher.

What the evidence base tells us:

• Radhakrishnan et al. 1994 reported an annual age-adjusted incidence of cervical radiculopathy of around 83 per 100,000 population, peaking in the 50 to 54 year age group. The C7 nerve root is most commonly affected, followed by C6.
• Wainner et al. 2003 validated a cluster of four tests. When all four are positive (Spurling, cervical distraction, upper-limb tension test, and cervical rotation under 60 degrees toward the symptomatic side), the positive likelihood ratio is approximately 30, a large shift in probability.
• Bono et al. 2011, the NASS evidence-based clinical guideline, positions history and physical examination as the foundation of diagnosis, with MRI reserved for persistent symptoms, progressive neurological deficit, or surgical consideration.

Sources: Radhakrishnan et al. (1994) Brain 117:325. Wainner et al. (2003) Spine 28:52. Bono et al. (2011) Spine Journal 11:64.

What the Research Suggests

Mainstream guidelines and systematic reviews support conservative care as the first step for suspected cervical radiculopathy in adults without red-flag features. The studies below summarise what the research suggests, not what any individual person will experience.

How Chiropractic Care May Help

Research suggests multimodal conservative care, including manual therapy, exercise, and neural mobilisation, may help reduce arm pain and disability in cervical radiculopathy for many people over the short-to-medium term, with low-to-moderate certainty. Individual responses vary, and referral is offered where clinically appropriate.

At Stapleton Chiropractic, care for suspected cervical radiculopathy is assessment-led and favours lower-force options first:

• Detailed history and red flag screen to confirm the presentation is consistent with mechanical nerve-root irritation and to rule out anything that warrants urgent medical review.
• Neurological screening including dermatomal sensation, myotomal strength (C5 through T1), reflex comparison, and provocation tests (Spurling, cervical distraction, upper-limb tension test).
• Low-force adjustment using an Activator instrument or drop-piece table. For true nerve-root involvement, these lower-force options are favoured. The Activator is a hand-held instrument that delivers a small, targeted impulse. The drop-piece table uses a gentle, mechanically assisted movement.
• Diversified manual adjustment only where clinically appropriate, reserved for patients comfortable with hands-on adjusting and where the clinical picture supports it.
• Soft tissue techniques including myofascial release, trigger-point work, and sub-occipital release for associated upper-neck tension that often guards around an irritated cervical segment.
• Neural mobilisation, graded exercise, and posture and workstation guidance, introduced progressively as symptoms settle.

Alongside in-clinic care, simple self-care strategies may help. These can include short, frequent movement breaks during long screen sessions, gentle range-of-motion exercises within comfortable limits, and avoiding sustained provocative postures. Progress is reviewed at each visit, and the plan is adjusted based on how symptoms are responding. There are no lock-in plans, and the decision to continue is always yours. Where symptoms are not progressing as expected, where red-flag features appear, or where imaging or specialist opinion may add value, referral back to your GP is offered.

Chiropractic vs other common approaches

If we feel you would benefit from a different approach, we will always let you know.

Pinched Nerve vs Other Arm and Neck Patterns

Not every arm pain is nerve-root pain, and not every tingling hand is coming from the neck. Careful differentiation matters because the most useful starting point depends on where the problem is most likely to be.

• Cervical radiculopathy: dermatomal arm pain, pins-and-needles, or weakness in a specific nerve-root distribution. Positive Spurling, cervical distraction relief, positive upper-limb tension test.
• General axial neck pain: neck, upper trapezius, and sometimes referred to the head or shoulder, without a clear dermatomal pattern or consistent neurological deficit.
• Whiplash: neck, headache, upper-back, occasional arm symptoms, following an acceleration-deceleration event such as a motor-vehicle collision.
• Thoracic outlet syndrome: medial arm or ulnar-side forearm symptoms, sometimes with vascular features. Positional provocation at the thoracic outlet.
• Carpal tunnel syndrome: median-nerve distribution in the hand, nocturnal symptoms, positive Phalen or Tinel at the wrist, normal neck exam.
• Cubital tunnel syndrome: ulnar-side forearm and hand symptoms, positive Tinel at the elbow, elbow-flexion provocation, normal neck exam.

Why Stapleton Chiropractic

Adult-first, evidence-informed, and family-run since 1972. No lock-in plans, clear pricing, and the decision is always yours.

What Your First Visit Looks Like

Four straightforward steps. No paperwork marathons, no surprises.

Transparent, Affordable Fees

No lock-in plans, no pressure. Fees sit well below the South Australian average.

Source: Australian Chiropractors Association Consultation Fee Survey 2025 (SA data). All major health funds accepted.

Warning Signs That Warrant Urgent Medical Review

Some features mean chiropractic care is not the first step, and a prompt medical review is more appropriate. If any of the following apply, please contact your GP or seek urgent medical care rather than booking a chiropractic consultation as a first step.

Seek prompt medical review if your neck or arm symptoms are accompanied by any of the following:

• Progressive weakness in the arm or hand, especially if it is worsening over days
• Sudden, severe neck pain alongside new neurological changes
• Signs that may suggest cervical myelopathy, including clumsy hands, difficulty with fine motor tasks like buttoning a shirt, unsteady gait, balance change, bilateral arm or leg symptoms, or exaggerated reflexes
• New bowel or bladder change
• Unexplained fever, night sweats, or significant unexplained weight loss
• Recent significant trauma, such as a fall from height or a motor-vehicle collision
• A personal history of cancer, particularly with new or unexplained neck or arm symptoms
• Severe unremitting night pain that does not settle with position change

If any of these features are present, please phone 000 for emergency symptoms, or contact your GP for same-day review. Dr Sam Johnson (Chiropractor) routinely screens for these features at the first visit and will refer onwards where clinically appropriate.

Frequently Asked Questions