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  • Chris' Corner
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    • Orthopedic Blog
  • Special Tests
    • Cervical Spine >
      • Alar Ligament Test
      • Bakody's Sign
      • Cervical Distraction Test
      • Cervical Rotation Lateral Flexion Test
      • Craniocervical Flexion Test (CCFT)
      • Deep Neck Flexor Endurance Test
      • Posterior-Anterior Segmental Mobility
      • Segmental Mobility
      • Sharp-Purser Test
      • Spurling's Maneuver
      • Transverse Ligament Test
      • ULNT - Median
      • ULNT - Radial
      • ULNT - Ulnar
      • Vertebral Artery Test
    • Thoracic Spine >
      • Adam's Forward Bend Test
      • Passive Neck Flexion Test
      • Thoracic Compression Test
      • Thoracic Distraction Test
      • Thoracic Foraminal Closure Test
    • Lumbar Spine/Sacroiliac Joint >
      • Active Sit-Up Test
      • Alternate Gillet Test
      • Crossed Straight Leg Raise Test
      • Extensor Endurance Test
      • FABER Test
      • Fortin's Sign
      • Gaenslen Test
      • Gillet Test
      • Gower's Sign
      • Lumbar Quadrant Test
      • POSH Test
      • Posteroanterior Mobility
      • Prone Knee Bend Test
      • Prone Instability Test
      • Resisted Abduction Test
      • Sacral Clearing Test
      • Seated Forward Flexion Test
      • SIJ Compression/Distraction Test
      • Slump Test
      • Sphinx Test
      • Spine Rotators & Multifidus Test
      • Squish Test
      • Standing Forward Flexion Test
      • Straight Leg Raise Test
      • Supine to Long Sit Test
    • Shoulder >
      • Active Compression Test
      • Anterior Apprehension
      • Biceps Load Test II
      • Drop Arm Sign
      • External Rotation Lag Sign
      • Hawkins-Kennedy Impingement Sign
      • Horizontal Adduction Test
      • Internal Rotation Lag Sign
      • Jobe Test
      • Ludington's Test
      • Neer Test
      • Painful Arc Sign
      • Pronated Load Test
      • Resisted Supination External Rotation Test
      • Speed's Test
      • Posterior Apprehension
      • Sulcus Sign
      • Thoracic Outlet Tests >
        • Adson's Test
        • Costoclavicular Brace
        • Hyperabduction Test
        • Roos (EAST)
      • Yergason's Test
    • Elbow >
      • Biceps Squeeze Test
      • Chair Sign
      • Cozen's Test
      • Elbow Extension Test
      • Medial Epicondylalgia Test
      • Mill's Test
      • Moving Valgus Stress Test
      • Push-up Sign
      • Ulnar Nerve Compression Test
      • Valgus Stress Test
      • Varus Stress Test
    • Wrist/Hand >
      • Allen's Test
      • Carpal Compression Test
      • Finkelstein Test
      • Phalen's Test
      • Reverse Phalen's Test
    • Hip >
      • Craig's Test
      • Dial Test
      • FABER Test
      • FAIR Test
      • Fitzgerald's Test
      • Hip Quadrant Test
      • Hop Test
      • Labral Anterior Impingement Test
      • Labral Posterior Impingement Test
      • Long-Axis Femoral Distraction Test
      • Noble Compression Test
      • Percussion Test
      • Sign of the Buttock
      • Trendelenburg Test
    • Knee >
      • Anterior Drawer Test
      • Dial Test (Tibial Rotation Test)
      • Joint Line Tenderness
      • Lachman Test
      • McMurray Test
      • Noble Compression Test
      • Pivot-Shift Test
      • Posterior Drawer Test
      • Posterior Sag Sign
      • Quad Active Test
      • Thessaly Test
      • Valgus Stress Test
      • Varus Stress Test
    • Foot/Ankle >
      • Anterior Drawer
      • Calf Squeeze Test
      • External Rotation Test
      • Fracture Screening Tests
      • Impingement Sign
      • Navicular Drop Test
      • Squeeze Test
      • Talar Tilt
      • Tarsal Tunnel Syndrome Test
      • Test for Interdigital Neuroma
      • Windlass Test
    • HEP >
      • Neck and Shoulder >
        • Supine Chin Tuck
        • Supine DNF with Towel Assist
        • Supine DNF
        • Standing Chin Tuck Against Wall
        • Standing Chin Tuck Against Wall with Scaption
        • Seated Cervical Retraction Repeated
        • Seated Cervical Retraction with Extension Repeated
        • Seated Cervical Retraction with Sidebend Repeated
        • Seated Cervical Retraction with Rotation Repeated
        • Standing Wall Shrugs at 90 Degrees Flex
        • Seated Thoracic Whips
        • Standing Ballistic Shoulder Extensions
        • Standing Repeated Shoulder Extension with Squat
        • Standing Repetead Shoulder Horiz. Abd. with Ext. CKC
        • Seated with Arms on Pillows Cervical AROM (Flex/Ext/Rot/SB)
        • Seated with Arms on Pillows Shrugs
        • Seated with Arms on Pillows Shrug with Scapular Retraction
        • Supine Shoulder IR with GH Centralization
        • Supine Shoulder ER with GH Centralization
        • Holding Dumbbell at 180 Degrees Flexion for Time
        • Cat Camel
        • Prone T's
        • Prone Y's
        • Quad Chin Tuck w/ Shoulder Flexion
      • Low Back >
        • Supine TA Isometric
        • Standing TA Isometric Agains Wall with Squat
        • Supine BKFO
        • Quad Rock Back
        • Standing Hip Hinge
        • Sit to Stand with Hip Hinge
        • Repeated Lumbar Sideglides
        • Repeated Standing Lumbar Extension
        • Repeated Standing Lumbar Flexion
        • Repeated Prone Press-Ups
        • Repeated Supine DKC
        • Slump Sciatic Nerve Glides
        • Birddog Progression
      • Hip and Knee >
        • Clamshells with Progressions
        • Fire Hydrants with Progressions
        • Donkey Kicks
        • Bridge Variations
        • Repeated Hip Flexion
        • Squats
        • Seated Repeated Knee Extensions
        • CKC Seated Repeated Knee Extensions
        • Heel Slides
        • CKC DF with Tibial IR
      • Foot and Ankle >
        • Calf Raises
        • Calf Raises with Soccer Ball Between Medial Malleoli
        • Towel Scrunches with Foot in PF
        • Toe Flexion Using T-Band with Foot in PF
        • PF with Toes Flexed Using T-Band
        • DF with Toes Flexed Using T-Band
        • Forefoot Adduction
        • Gastroc Stretch
        • Repeated PF
      • Examination Templates

Orthopedic & Manual Therapy Blog

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Cervical Radiculopathy vs. Myelopathy

11/1/2019

0 Comments

 

Can you answer these questions?  (Answers in post!)

  1. Is radiculopathy an upper motor neuron OR lower motor neuron problem?
  2. What is the plan of care for someone with cervical myelopathy (treat, refer out, both)?
  3. What are the 4 clinical criteria for a diagnosis of cervical radiculopathy?

Key Information to Know

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Chronic cervical degeneration is the most common cause of progressive spinal cord and nerve root compression. These spondylotic (arthritic) changes can result in stenosis of the spinal canal, lateral recess, and/or foramina. Stenosis is defined as ANY narrowing of a canal leading to nerve compression. When stenosis occurs centrally, compressing the spinal cord, it is called myelopathy. When stenosis occurs laterally, compressing the nerve roots, it is called radiculopathy.
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Cervical Myelopathy

Central spinal stenosis is known as myelopathy. An individual with myelopathy will present with Upper Motor Neuron signs and symptoms. These symptoms include gait ataxia, a positive Babinski test, a positive Inverted Supinator sign, a positive Hoffman's test, hyperreflexia, potential bowel and bladder changes, among other findings. Since the spinal cord is compressed, a referral for imaging is recommended to assess the amount of compression. Assuming the patient does not have severe compression with hard neurological findings, the patient will likely be appropriate to continue resume their Physical Therapy plan of care. ​
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Cervical Radiculopathy

Cervical radiculopathy has many different symptoms than myelopathy. In radiculopathy, the nerve root (not the spinal cord) is the involved structure. When the nerve root is placed under compression or tension (or any additional stress), individuals will typically have a myotomal pattern of weakness, a dermatomal pattern of sensory loss, hyporeflexia, positive Spurlings Maneuver, positive Distraction Test, decreased cervical rotation to the involved side, and a positive median nerve tension test. 
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Cervical Radiculopathy Case Study

See how Dr. Chris Fox PT, DPT, OCS treats Cervical Radiculopathy

For more information on treating cervical radiculopathy and myelopathy, please check out our new course on the ​Orthopedic Management of the Cervical Spine! In this course, we cover cervical anatomy, examination, differential diagnosis, advanced treatment strategies, case studies, and more!

References:
1. Kadanka Z, Bednarík J, Vohánka S, Vlach O, Stejskal L, Chaloupka R, Filipovicová D, Surelová D, Adamová B, Novotný O, Nemec M, Smrcka V, Urbánek I. Conservative treatment versus surgery in spondylotic cervical myelopathy: a prospective randomised study. Eur Spine J (2000) 9 :538–544
2. Cleland JA, Fritz JM, Whitman JM, et al. Predictors of short-term outcomes in people with a clinical diagnosis of cervical radiculopathy. Phys Ther. 2007;87(12):1619-1632
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    Dr. Jim Heafner & Dr. Chris Fox write about their treatment philosophy.

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Copyright © The Student Physical Therapist LLC 2020
  • Home
    • Newsletter
    • About
  • Insider Access
    • About Insider Access
  • Brian's Corner
    • Sports & Entrepreneurship Blog
    • Return to Sport Tests
    • PT Entrepreneur Course
    • Return to Sport Essentials Course
    • Become a PAID PT Consultant Course
  • Chris' Corner
  • Jim's Corner
    • Orthopedic Blog
  • Special Tests
    • Cervical Spine >
      • Alar Ligament Test
      • Bakody's Sign
      • Cervical Distraction Test
      • Cervical Rotation Lateral Flexion Test
      • Craniocervical Flexion Test (CCFT)
      • Deep Neck Flexor Endurance Test
      • Posterior-Anterior Segmental Mobility
      • Segmental Mobility
      • Sharp-Purser Test
      • Spurling's Maneuver
      • Transverse Ligament Test
      • ULNT - Median
      • ULNT - Radial
      • ULNT - Ulnar
      • Vertebral Artery Test
    • Thoracic Spine >
      • Adam's Forward Bend Test
      • Passive Neck Flexion Test
      • Thoracic Compression Test
      • Thoracic Distraction Test
      • Thoracic Foraminal Closure Test
    • Lumbar Spine/Sacroiliac Joint >
      • Active Sit-Up Test
      • Alternate Gillet Test
      • Crossed Straight Leg Raise Test
      • Extensor Endurance Test
      • FABER Test
      • Fortin's Sign
      • Gaenslen Test
      • Gillet Test
      • Gower's Sign
      • Lumbar Quadrant Test
      • POSH Test
      • Posteroanterior Mobility
      • Prone Knee Bend Test
      • Prone Instability Test
      • Resisted Abduction Test
      • Sacral Clearing Test
      • Seated Forward Flexion Test
      • SIJ Compression/Distraction Test
      • Slump Test
      • Sphinx Test
      • Spine Rotators & Multifidus Test
      • Squish Test
      • Standing Forward Flexion Test
      • Straight Leg Raise Test
      • Supine to Long Sit Test
    • Shoulder >
      • Active Compression Test
      • Anterior Apprehension
      • Biceps Load Test II
      • Drop Arm Sign
      • External Rotation Lag Sign
      • Hawkins-Kennedy Impingement Sign
      • Horizontal Adduction Test
      • Internal Rotation Lag Sign
      • Jobe Test
      • Ludington's Test
      • Neer Test
      • Painful Arc Sign
      • Pronated Load Test
      • Resisted Supination External Rotation Test
      • Speed's Test
      • Posterior Apprehension
      • Sulcus Sign
      • Thoracic Outlet Tests >
        • Adson's Test
        • Costoclavicular Brace
        • Hyperabduction Test
        • Roos (EAST)
      • Yergason's Test
    • Elbow >
      • Biceps Squeeze Test
      • Chair Sign
      • Cozen's Test
      • Elbow Extension Test
      • Medial Epicondylalgia Test
      • Mill's Test
      • Moving Valgus Stress Test
      • Push-up Sign
      • Ulnar Nerve Compression Test
      • Valgus Stress Test
      • Varus Stress Test
    • Wrist/Hand >
      • Allen's Test
      • Carpal Compression Test
      • Finkelstein Test
      • Phalen's Test
      • Reverse Phalen's Test
    • Hip >
      • Craig's Test
      • Dial Test
      • FABER Test
      • FAIR Test
      • Fitzgerald's Test
      • Hip Quadrant Test
      • Hop Test
      • Labral Anterior Impingement Test
      • Labral Posterior Impingement Test
      • Long-Axis Femoral Distraction Test
      • Noble Compression Test
      • Percussion Test
      • Sign of the Buttock
      • Trendelenburg Test
    • Knee >
      • Anterior Drawer Test
      • Dial Test (Tibial Rotation Test)
      • Joint Line Tenderness
      • Lachman Test
      • McMurray Test
      • Noble Compression Test
      • Pivot-Shift Test
      • Posterior Drawer Test
      • Posterior Sag Sign
      • Quad Active Test
      • Thessaly Test
      • Valgus Stress Test
      • Varus Stress Test
    • Foot/Ankle >
      • Anterior Drawer
      • Calf Squeeze Test
      • External Rotation Test
      • Fracture Screening Tests
      • Impingement Sign
      • Navicular Drop Test
      • Squeeze Test
      • Talar Tilt
      • Tarsal Tunnel Syndrome Test
      • Test for Interdigital Neuroma
      • Windlass Test
    • HEP >
      • Neck and Shoulder >
        • Supine Chin Tuck
        • Supine DNF with Towel Assist
        • Supine DNF
        • Standing Chin Tuck Against Wall
        • Standing Chin Tuck Against Wall with Scaption
        • Seated Cervical Retraction Repeated
        • Seated Cervical Retraction with Extension Repeated
        • Seated Cervical Retraction with Sidebend Repeated
        • Seated Cervical Retraction with Rotation Repeated
        • Standing Wall Shrugs at 90 Degrees Flex
        • Seated Thoracic Whips
        • Standing Ballistic Shoulder Extensions
        • Standing Repeated Shoulder Extension with Squat
        • Standing Repetead Shoulder Horiz. Abd. with Ext. CKC
        • Seated with Arms on Pillows Cervical AROM (Flex/Ext/Rot/SB)
        • Seated with Arms on Pillows Shrugs
        • Seated with Arms on Pillows Shrug with Scapular Retraction
        • Supine Shoulder IR with GH Centralization
        • Supine Shoulder ER with GH Centralization
        • Holding Dumbbell at 180 Degrees Flexion for Time
        • Cat Camel
        • Prone T's
        • Prone Y's
        • Quad Chin Tuck w/ Shoulder Flexion
      • Low Back >
        • Supine TA Isometric
        • Standing TA Isometric Agains Wall with Squat
        • Supine BKFO
        • Quad Rock Back
        • Standing Hip Hinge
        • Sit to Stand with Hip Hinge
        • Repeated Lumbar Sideglides
        • Repeated Standing Lumbar Extension
        • Repeated Standing Lumbar Flexion
        • Repeated Prone Press-Ups
        • Repeated Supine DKC
        • Slump Sciatic Nerve Glides
        • Birddog Progression
      • Hip and Knee >
        • Clamshells with Progressions
        • Fire Hydrants with Progressions
        • Donkey Kicks
        • Bridge Variations
        • Repeated Hip Flexion
        • Squats
        • Seated Repeated Knee Extensions
        • CKC Seated Repeated Knee Extensions
        • Heel Slides
        • CKC DF with Tibial IR
      • Foot and Ankle >
        • Calf Raises
        • Calf Raises with Soccer Ball Between Medial Malleoli
        • Towel Scrunches with Foot in PF
        • Toe Flexion Using T-Band with Foot in PF
        • PF with Toes Flexed Using T-Band
        • DF with Toes Flexed Using T-Band
        • Forefoot Adduction
        • Gastroc Stretch
        • Repeated PF
      • Examination Templates