What is a red flag for radiculopathy?

Weakness that is getting worse, clumsy hands, trouble with balance or walking, and any bladder or bowel changes are red flags that need a physician right away. Arm pain with chest pressure or shortness of breath needs 911. A pinched nerve with stable symptoms and none of these signs is generally appropriate to start treating in physical therapy.

What makes radiculopathy worse?

In the neck, looking up or over your shoulder and long stretches of sitting with your head forward often aggravate symptoms. In the low back, sitting, coughing, sneezing and straining commonly do. The specific movements vary from person to person, which is why we test them instead of guessing.

Can a pinched nerve heal on its own?

Often, yes. The American Academy of Orthopaedic Surgeons notes that most people with a pinched nerve in the neck improve over time, some within days or weeks. Physical therapy helps you manage symptoms while that happens and gives you tools for a flare, and worsening weakness always needs a physician.

Can a pinched nerve in the neck cause shoulder pain?

Yes. Irritation of the C5 nerve root, for example, can cause shoulder pain and numbness along the outside of the upper arm. Shoulder problems can also mimic a pinched nerve, so we test both the neck and the shoulder before deciding what to treat.

Pinched Nerve Treatment in Buffalo, NY | Lake Erie Physical Therapy

Burning that runs from your neck to your thumb. Pins and needles in two fingers. A grip that feels weaker when you pour your coffee. Those are typical signs of a pinched nerve, which clinicians call radiculopathy: a nerve root that’s compressed or irritated where it branches off the spinal cord. This page covers pinched nerve treatment for the neck (cervical radiculopathy) and the low back (lumbar radiculopathy, usually called sciatica), and how Lake Erie Physical Therapy in Buffalo approaches both.

Where the nerve gets pinched

In the neck

Cervical radiculopathy usually comes from age-related changes: discs lose height, bone spurs form, and the openings where nerves leave the spine narrow. In younger people, a herniated disc after a sudden injury is the more common cause, though sometimes no injury is involved at all.

Each nerve root serves a different strip of the arm, so where you feel symptoms is a clue. APTA’s guide to cervical radiculopathy describes these patterns:

Nerve root	Where you may feel it	What may weaken
C5	Shoulder and outer upper arm	Deltoid, the muscle that lifts the arm out to the side
C6	Thumb side of the forearm and hand	Biceps and the muscles that lift the wrist
C7	Back of the arm and the middle finger	Triceps and the muscles that curl the wrist
C8	Little finger and inner forearm	Grip

C6 and C7 are the levels most often affected. Looking up or over your shoulder often makes symptoms worse, and some people get relief by resting a hand on their head, which eases tension on the nerve.

Other problems can mimic a pinched nerve, including shoulder conditions, nerve entrapment at the elbow or wrist (such as carpal tunnel syndrome) and even heart disease, so the exam matters more than any single symptom.

In the low back

Lower down, a herniated disc or spinal stenosis can pinch a nerve root and send pain, numbness or weakness down the leg. Our sciatica and herniated disc pages cover that in detail, and the assessment works the same way.

Symptoms that can’t wait

A pinched nerve and a squeezed spinal cord are different problems. Physical therapy does not replace a medical diagnosis, and these signs need a physician first:

Clumsy hands or poor balance. Trouble with buttons, handwriting or holding onto objects, an unsteady walk or falls can mean spinal cord compression in the neck (myelopathy).
Weakness that’s getting worse, such as a hand that keeps dropping things or a foot that slaps or drags.
Bladder or bowel changes, or numbness between the legs. Go to an emergency department.
Arm pain with chest pressure, shortness of breath or sweating. Call 911.
Symptoms after a significant injury, such as a fall or car accident.
Fever, unexplained weight loss or a history of cancer along with new nerve symptoms.

Our approach to pinched nerve treatment

The encouraging part first: the American Academy of Orthopaedic Surgeons (AAOS) notes that in most cases, cervical radiculopathy responds well to conservative care, including physical therapy, and does not require surgery. From there:

We map the symptoms. We chart exactly where pain, tingling and numbness reach and test strength, sensation and reflexes, so change can be measured visit to visit.
We test movement with the McKenzie Method (MDT). Repeated neck or back movements show whether arm or leg symptoms retreat toward the spine or spread farther out. Movements that pull symptoms back toward the spine become your home program, and anything that sends them farther down the limb gets dropped. Here’s more on how McKenzie testing works.
We use traction when it fits. For some neck cases, mechanical traction (a gentle pull in line with the spine) can ease pressure, and we use it when your exam suggests it will help.
We adjust posture and work setup: screen height, phone habits, sleeping position and how long you sit at a stretch.
We strengthen once the arm settles. APTA’s guidance is that exercises early on shouldn’t increase arm pain, and that more demanding strengthening waits until pain no longer runs down the arm.
We add hands-on manual therapy for stiff joints and guarded muscles when it helps you move.

A word about imaging: AAOS notes that nearly half of middle-aged and older adults have worn discs and pinched nerves that cause no painful symptoms. An MRI finding matters when it matches your symptoms and exam.

How long recovery takes

It varies. Some people feel better within days or weeks, and others take longer. It’s also common for a pinched nerve in the neck that has settled to flare again later, and it usually improves again. We recheck strength and sensation as you go, and if weakness gets worse instead of better, we contact your physician rather than wait it out.

With most plans, New York lets you start physical therapy without a referral for 10 visits or 30 days, whichever comes first. If your arm or leg has been burning, buzzing or tingling for more than a few days, call (716) 332-4838 or ask for an appointment online.

Sources

Written by the Lake Erie Physical Therapy clinical team. This page is general information, not a diagnosis; your physical therapist will assess your situation in person.

Physical Therapy for a Pinched Nerve