From the Research
The best treatment for cervical radiculopathy in an urgent care setting involves a multimodal approach focusing on pain relief and reducing nerve inflammation, with the most recent and highest quality evidence supporting the use of oral NSAIDs, muscle relaxants, and a short course of oral steroids. According to 1, cervical radiculopathy can be managed nonoperatively with physical therapy, nonsteroidal anti-inflammatory drugs, muscle relaxants, and massage. The initial management should include oral NSAIDs such as ibuprofen 400-600mg every 6-8 hours or naproxen 500mg twice daily for 1-2 weeks, combined with muscle relaxants like cyclobenzaprine 5-10mg at bedtime for 1 week if muscle spasms are present. A short course of oral steroids may be beneficial, such as a methylprednisolone dose pack or prednisone 20mg daily for 5-7 days with tapering.
Some key points to consider in the management of cervical radiculopathy include:
- Patients should be advised to apply ice for the first 48-72 hours (20 minutes on, 40 minutes off), followed by heat therapy.
- Activity modification is crucial—patients should avoid activities that exacerbate symptoms but maintain gentle movement rather than strict immobilization.
- A soft cervical collar may provide temporary relief but should be limited to 3-5 days to prevent muscle weakening.
- Patients should be instructed on proper posture and ergonomics, and referred for follow-up with primary care within 1-2 weeks.
- Physical therapy referral should be considered if symptoms persist beyond 2-3 weeks, as supported by 2 and 3.
It's essential to note that most patients with cervical radiculopathy will improve with nonoperative treatment, and surgery is typically reserved for those with significant motor deficits, debilitating pain, or instability, as stated in 4. By following a multimodal approach and considering the individual patient's needs and symptoms, healthcare providers can effectively manage cervical radiculopathy in an urgent care setting and improve patient outcomes.