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  • Q&A with Australian Health Practitioners

    What are the best treatments for neck pain/pinched nerve between C4/C5?

    Related Topics
    Cardiology & Vascular Health Fitness and Sports Medicine Migraines & Headaches
    I have had MRI and seen a neurosurgeon who confirms pinching/pressed nerve from disc bulging/pressing nerve on the right side between the C4/C5 - there is also some slight pinching between C6/C7 but less so. I wake up with a stiff neck, headaches and am very tired. Waking up in mornings is when the discomfort is at its worst. Its takes about 3 hours until I feel reasonably normal. I am seeking advice for exercises and treatments that may assist reduce the pain.
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    Brian Lee

    Physiotherapist

    I graduated from the University of Melbourne in 2004 and have worked in various healthcare settings, including primary care, private practice and community health services, … View Profile

    There is no such thing as the general best treatment, but rather best principle, as the treatments need to be prescribed individually subject to the physio objective assessment results. 

    The principle may not be of much use to you, as there is a gap on how to form and implement suitable treatments to meet the principles. But here are the principles:

    - nerve compression is a result, not so much the cause for neck stiff; it's rather the cause for referred pain (but you haven't mentioned, so I assume the referred pain is either non exist or not of your main concern)

    - neck / joint ROMs need to be kept optimal

    - environmental factors needs to be investigated, i.e. pillow, chair

    - posture need to be addressed, if found contributing to the problem

    neck stiffness is mainly caused by malalignment, disc, joint or muscle problem, with some % of sufferers' cases that are due to apprehension. 

    joint can be categorized into deformed or non deformed, and they have different type of presentations under each sub-category, hence treatment approach is different subject to assessment finding

    muscle can be tight, jerky contracting, thickened, imbalance..etc, all of these can also contribute to neck stiffness, and again, treatment approach is different across the board. 

    loss of disc height can often contribute to some degree of stiffness, but with differnt kind of disc pathologies, e.g. bulge, prolapse, loss of height, spondylolithesis ..etc, it's another huge topic of discussion.

    On the other hand, further Q needed to be asked by your treating physio on what you described as discomfort, as discomfort can be pain, stiff, combination of both, or in other form. Once this is clarified, specific assessments need to be conducted to investigate the cause of this discomfort, before formulating treatment strategies. Just because there is nerve compression found, it doesn't mean every discomfort you've experienced in neck is all coming from this compression.

    An experienced physio would know what he / she is doing, so able to provide you more immediate result and carry-over effect, hence gradual recovery; less experienced clinician may have no idea what to look for or may require more sessions of trials and errors before getting the root cause of your neck stiffness right. 

    Maybe speak to your local experienced physio will be a good start. 

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    Dr Daryl Ansell

    Chiropractor

    There is not enough information to give you good advice here. If you have compression of a nerve root exiting the spine you should have symptomology specific to that nerve root. (Pain numbness loss of muscle strength etc) If you only have a stiff neck is it possible that the disc is a complicating factor however biomechanical issues could be involved as well. Indeed many people with bulging discs are walking around totally asymptomatic so never assume that the presence of a buging disc guarantees that it is the cause of your symptoms.

    Get a thorough exam of your neck not just a review of your MRI's an example is below 

    https://www.youtube.com/watch?v=ZNhSa5E_mHs

    Also there are stretching exercises on our website that could be of great help to you.

    http://www.ansellchiropractic.com.au/spinal-exercises/

    Good luck

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  • Christine Guirguis

    Acupuncturist, Chinese Herbal Medicine Practitioner

    Christine Guirguis studied at the University of Sydney and the University of Technology Sydney, obtaining degrees in medical science and health sciences in acupuncture and … View Profile

    Acupuncture for the pain, heaches and fatigue; physio for a stretching (and perhaps strengthening) prescription

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    Dr Steve Grant

    Osteopath

    OsteopathyMyofascial ReleaseAcupuncture Voice Dialogue facilitator View Profile

    Hi there

    There are several suggestions that may provide relief. I believe that the first step is to assess the patients posture both at home when performing household duties and at work for lengthy periods.

    Some people can gain great benefit from these simple assessments. It is then important to help them manage this and to reinforce the correction with ongoing monitring.

    Steve

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