Case study

The case describes a 37-year-old construction worker with left-sided neck and arm pain radiating to the thumb, weakness in left arm movement, and sensory changes. His symptoms started after lifting a heavy object, and his examination findings suggest C5-C6 nerve root involvement.

Key findings:

• Pain and weakness in the left arm, particularly elbow flexors and wrist extensors (C6 myotome).

• Sensory deficits in the left thumb and index finger (C6 dermatome).

• Positive Spurling’s test, indicating cervical radiculopathy.

• MRI findings: C5-C6 disc protrusion and foraminal stenosis, confirming nerve root compression.

The most likely diagnosis is C6 radiculopathy due to cervical disc herniation at C5-C6. Management typically includes physical therapy, NSAIDs, and possibly epidural steroid injections, with surgery considered for persistent or severe cases.

Treatment Options for C6 Radiculopathy Due to C5-C6 Disc Herniation

Treatment depends on the severity of symptoms, duration, and impact on daily life. The approach includes conservative management, interventional procedures, and surgical options if necessary.

Conservative Management (First-line treatment)

Most patients improve with non-surgical care within 6–12 weeks.

• Activity modification: Avoid heavy lifting, overhead activities, or movements that worsen symptoms.

• Physical therapy (PT):

• Cervical traction to relieve pressure on the nerve root.

• Postural training and ergonomic adjustments.

• Strengthening exercises for neck and scapular stabilizers.

• Nerve gliding exercises to reduce nerve irritation.

• Pain management:

• NSAIDs (e.g., ibuprofen, naproxen) for inflammation and pain relief.

• Muscle relaxants (e.g., cyclobenzaprine, tizanidine) if muscle spasms are present.

• Neuropathic pain medications (e.g., gabapentin, pregabalin, or amitriptyline) if radicular pain persists.