NECK PAIN

Numbness, tingling or weakness radiating from the neck into the arm, forearm or hand indicates nerve involvement (cervical

radiculopathy) and should always be properly assessed. The most common causes are a disc bulge compressing a nerve root, foraminal stenosis due to arthritic changes, or facet joint inflammation irritating adjacent nerves.

Symptoms include:

Electric or burning pain tracking down one arm, numbness or altered sensation in the hand or fingers, muscle weakness when gripping or lifting, and reduced deep tendon reflexes (assessed

by your osteopath).

How we treat it:

A thorough neurological assessment identifies the affected nerve root level. Neural mobilisation ("nerve flossing") reduces nerve

tension and sensitisation. Cervical traction — applied manually or via a traction device — decompresses the affected disc or foramen. Joint mobilisation reduces periarticular inflammation.

Most cases respond well to conservative osteopathic care. Where imaging is required or surgical referral is indicated, we coordinate promptly with your GP.

Thoracic outlet syndrome (TOS) occurs when nerves or blood vessels become compressed in the narrow space between the collarbone, first rib and scalene muscles — the "thoracic outlet". It can be caused by anatomical variations (cervical rib), postural collapse of the shoulders, or hypertrophy of the scalene muscles in overhead athletes.

Symptoms include:

Pain, numbness and tingling in the neck, shoulder, arm or hand; hand weakness; a pale or bluish arm; and symptoms that worsen with overhead activities or holding the arm raised.

How we treat it:

We assess posture, first rib mobility, scalene muscle length and upper thoracic mechanics to identify the specific compression site. First rib mobilisation is often a key treatment. Scalene and pectoralis minor stretching combined with shoulder girdle

strengthening relieves vascular and neural compression. Postural re-education is essential for lasting improvement. We work

collaboratively with vascular specialists when vascular TOS is suspected.

A cervical disc bulge or herniation occurs when the nucleus pulposus of an intervertebral disc extrudes through the outer annulus fibrosus, potentially compressing an adjacent nerve root or, less commonly, the spinal cord. Levels C5–C6 and C6–C7 are most frequently affected. Most cases resolve with conservative

management within six to twelve weeks.

Symptoms include:

Neck pain with radiation into the arm following a dermatomal pattern, sharp or burning quality, muscle weakness in specific

muscle groups, and sensory changes in the hand or fingers.

Central disc herniations causing cord compression require urgent referral.

How we treat it:

Cervical traction reduces intradiscal pressure and decompresses the nerve root. Neural mobilisation addresses nerve tension downstream. Gentle joint mobilisation maintains segmental

mobility without aggravating the disc. Core and deep neck flexor strengthening builds the muscular support needed to take load off injured discs. Shockwave therapy can reduce periarticular

inflammation. We monitor red flags carefully and coordinate

imaging or specialist referral when required.

Cervical osteoarthritis — also known as cervical spondylosis — is the gradual degeneration of the cartilage, facet joints and intervertebral discs of the cervical spine. It is a normal part of ageing and is present in most adults over 50, though not all experience symptoms. When symptomatic, it can significantly affect comfort and quality of life.

Symptoms include:

Persistent neck stiffness (especially in the morning), grinding or clicking with movement, reduced range of rotation and extension, headaches at the base of the skull, and in some cases radiating pain or arm symptoms from associated nerve root irritation.

How we treat it:

While arthritic changes cannot be reversed, pain, stiffness and

function can be substantially improved. Osteopathic joint

mobilisation maintains cervical movement and reduces arthritic stiffness. Soft tissue therapy relieves compensatory muscle overload. Therapeutic exercise maintains neck strength and proprioception, which is important for long-term management.

Heat, TENS and activity pacing advice support day-to-day

comfort. Regular maintenance osteopathy appointments are a

cost-effective strategy for managing long-term cervical

spondylosis.