Compression of nerve roots as they exit the through a bony canal (foramina) in the neck vertebra can produce symptoms remote from the neck (radiculopathy), along with neck pain. Most compression is due to a bulging disc, while about 10% are caused by bone outgrowths (osteophytes).

Symptoms include pain (sharp or dull), weakness, wasting of muscle, numbness and tingling. 

The most common site of compression occurs at the seventh neck vertebra (C7), followed by C6. C7 nerve root compression typically radiates pain into the shoulder blade, down the back of the arm and into the middle finger. C6 radiates pain into the outer aspect of the elbow and into the thumb. C5 typically radiates to the outer aspect of the shoulder. Nerve root compression at the upper neck levels radiates pain into the base of the skull (occiput) and around the ear.

In rare cases, where there is profound motor weakness or signs of spinal cord involvement (myelopathy), urgent surgery is required. In the majority of cases symptoms will resolve with conservative, as opposed to surgical, treatment.

Osteopathic treatment may help relieve nerve root compression by : reducing muscle spasm; decompressing disc pressure; remodelling disc architecture; stimulating disc regeneration; and by improving blood supply and nerve activity so the tissues can heal unimpeded.

To achieve long term resolution it is important to identify and manage underlying causative and maintaining factors.