Trapped nerve in the neck: symptoms, treatment and how long it lasts

NICE CKS describes cervical radiculopathy as pain and weakness and/or numbness in one or both of the upper limbs, corresponding to the involved cervical nerve root, and often with neck pain. Pain can also be experienced in the shoulders, upper back and chest.

Bexley MSK Service says it often causes pain to be felt all the way down the arm, and can cause pins and needles, numbness and weakness in the arm and hand. Norfolk and Waveney MSK services add that it may cause pain in the neck and shoulder blade that travels down the arm, possibly to the fingers, and that pain on turning your head, looking up or moving your arm is common. The neck may feel stiff or tight, and sometimes there are no pain symptoms at all.

• Neck pain, often with pain in the shoulder blade, shoulder or upper back.

• Pain that travels down the arm, possibly to the fingers.

• Pins and needles or numbness in the arm or hand.

• Weakness in the arm or hand.

• Neck stiffness, and pain on turning the head, looking up or moving the arm.

• Sometimes headaches, linked to neck muscle tension (Norfolk and Waveney).

NICE CKS says that for people with neck pain for less than 4 to 6 weeks and no objective neurological signs, management includes reassurance, information and advice, oral pain relief, and consideration of nerve pain medicines (amitriptyline, duloxetine, pregabalin or gabapentin) and of a referral for physiotherapy.

The NHS says you can ease neck pain yourself with paracetamol or ibuprofen (or ibuprofen gel), a low firm pillow, heat or cold packs and neck flexibility exercises. It advises against wearing a neck collar, because it is better to keep your neck moving unless a doctor tells you not to. Norfolk and Waveney say collars are no longer recommended because keeping the neck still causes strength loss and can make you more fearful of moving.

Bexley MSK says exercise helps manage symptoms, and that postural awareness, a supportive pillow and a good workstation can make a difference. It also suggests modifying activities that aggravate symptoms.

NICE CKS says most people with cervical radiculopathy will improve regardless of treatment, and around 88% improve within four weeks with non-operative management. Local NHS MSK services give a slightly longer guide: Bexley says symptoms are likely to settle within 6 to 12 weeks.

Norfolk and Waveney say people often notice signs of improvement within weeks to months if they are consistent with exercise, and that progress usually comes in small amounts and is more likely to take weeks than days. If you are not improving, they advise speaking to your physiotherapist or GP.

NICE CKS says cervical radiculopathy is usually caused by compression of the nerve root due to cervical disc herniation or degenerative changes (spondylosis), but symptoms can also occur without evident compression, for example due to inflammation of the nerve. It is most common in people aged 50 to 54.

Both local MSK services stress that the phrase trapped nerve can mislead. Bexley says MRI scans show many people with these symptoms do not have anything pressing on a nerve, and inflammation of nearby structures is a likely trigger. Norfolk and Waveney say nerves are sensitive and get irritated rather than trapped, and the problem is not damaging.

The NHS lists common causes of neck pain as the neck locking in an awkward position while sleeping, bad posture, a pinched nerve, or an injury such as whiplash.

NICE CKS says assessment should exclude red flag features of serious spinal problems, ask about symptoms and examine for signs, using a combination of tests such as the Spurling test and arm squeeze test. It says X-rays and other imaging are not normally required.

Norfolk and Waveney explain that scans do not always show what you think: many so-called worn or abnormal findings are seen commonly in people with no symptoms. NICE CKS says people with symptoms present for 4 to 6 weeks or more, or with objective neurological signs, should be referred for MRI and for invasive procedures to be considered.

Norfolk and Waveney list features that are rare with cervical radiculopathy and need urgent medical attention. The NHS says to see a GP if neck pain does not go away after a few weeks, painkillers have not worked, you are worried, or you have other symptoms like pins and needles or a cold arm, which could be something more serious.

• Difficulty coordinating your arms or legs.

• Pins and needles or numbness in both arms, both legs or all limbs.

• Changes in bladder, bowel or sexual function.

• Feeling generally unwell or having a temperature with neck pain, or neck pain after trauma.

• Symptoms that travel into the face, changes in vision, speech or hearing, or unusual headaches.

• Shortness of breath, particularly if you smoke.

The NHS says in many areas you can refer yourself for physiotherapy from community musculoskeletal (MSK) services without a GP referral. Care usually starts with advice and exercise. Private physiotherapy or an MRI may be quicker to arrange, but NICE CKS suggests scans are not normally needed, so it is worth asking a clinician whether one is likely to change management.