Surgery for cervical
radiculopathy

Is surgery right for cervical radiculopathy?

Cervical radiculopathy is often called a “pinched nerve” in the neck and Most people with this problem improve with time and non-surgical care. Surgery is usually only discussed when symptoms are truly limiting for an extended period, or when nerve function is at risk. ¹ ² ³

Surgery might be considered if:

• arm pain stays severe and disabling, even after a solid course of conservative care like education and guided physical therapy. ¹ ³
• weakness is getting worse, or you are losing function in the arm or hand. ¹ ³
• there are signs of spinal cord compression (cervical myelopathy), such as balance changes or increasing hand clumsiness, which needs urgent specialist assessment. ³

Surgery is not the automatic next step for everyone because many people get better without it, even if an MRI shows a bulging disc or arthritis changes. ⁴ ⁵ Surgery is designed to address specific nerve pressure, but it cannot always guarantee symptom relief, especially if pain has multiple contributors. ¹ ³

Ideally, you and your clinician review the following factors and come to a shared decision on whether surgery is required:

• your symptoms and exam findings
• whether imaging matches the nerve involved
• your daily goals and worries
• the likely benefits and the real risks of each option ¹ ² ⁶

Common surgical options for cervical radiculopathy

Your surgeon may discuss a few approaches, depending on where the nerve is being pinched and what your spine looks like.

• Anterior cervical discectomy and fusion (ACDF): This procedure removes the problem disc or bone pressure from the front of the neck, then fuses the bones at that level to keep it stable. ¹ Fusion can limit movement and mobility, so non-surgical options should be explored before opting for this. ¹
• Cervical disc arthroplasty (disc replacement): Replaces the disc with an artificial disc to relieve nerve pressure while preserving more motion than with a fusion procedure. This is rarely used and only in carefully selected instances as the surgery carries significant risk. ⁷
• Posterior cervical foraminotomy: Relieves pressure on the nerve from the back of the neck by widening the nerve “exit tunnel,” often without fusion. In a randomized trial, this approach had outcomes that were not worse than ADCF for certain single-level cases, with different tradeoffs in recovery and risks. ⁶

What to expect during recovery

Recovery varies by person and by procedure, but most people go through a few common phases.

• Early phase (first days to weeks): It is normal to have post-surgical soreness, and your arm symptoms may improve quickly or more gradually. ¹ ⁶ You may have activity restrictions for a period of time, especially after fusion. ¹
• Rebuilding phase (weeks to months): Many people need a structured plan to rebuild neck and shoulder strength, restore confidence with daily activity, and return to work or sport safely. ¹ ⁸ Progress is often steadier when rehab is gradual and goal-based, rather than pushing through sharp nerve symptoms. ⁸
• Common challenges: Include sleep disruption, fatigue, and stiffness are common early on. ¹ Some people improve a lot, others improve partially, and a smaller group may continue to have symptoms even after surgery. ¹ ⁶

Potential risks of surgery for a pinched nerve

All surgeries carry risks, and the exact risk profile depends on the procedure and your health. Risks commonly discussed include:

• Infection, bleeding, and nerve irritation. ¹
• Persistent or recurrent symptoms, including the possibility of needing another procedure later. ⁴ ⁶
• After fusion, there can be extra stress on nearby levels over time, although not everyone develops problems from this. ⁷

If you are considering surgery, ask your surgeon what recovery usually looks like for their patients with your specific situation, and what a “good outcome” realistically means for you.

Can surgery be avoided?

For many people, yes. Cervical radiculopathy often improves with education, activity changes, and a structured physical therapy program, especially when symptoms are monitored and progressed in a steady way. clinical guidance also supports delaying imaging and procedures unless there are red flags, worsening nerve loss, or persistent disability despite good conservative care. ² ³ ⁸

Non-surgical care like physical therapy can target things surgery does not, like reducing the sensitivity of the irritated nerve, building strength and endurance around the neck and shoulder blade, and improving sleep and confidence with movement ⁸ ⁹

You can learn more from our physical therapy for a cervical radiculopathy guide.

How Sword can support you before and after surgery

Physical therapy can play an important role in preparing for surgery, supporting recovery, and, in some cases, helping people manage symptoms without surgery. Sword offers AI Care physical therapy programs supported by expert specialists designed to help you recover faster and eliminate your symptoms.

Sword supports recovery before and after surgery, with care designed to fit into your life. You receive high-quality physical therapy at home, guided by licensed clinicians and supported by smart technology.

• Care that adapts as your body and recovery needs change
• Licensed physical therapists guiding your care at every stage
• Non-invasive, evidence-based physical therapy programs

Clinical insight

Often you don't need imaging for a pinched nerve problem. Clinical guidance emphasizes that an MRI is most useful when there are red flags, progressive nerve loss, or when symptoms persist and you are considering injections or surgery. in many straightforward cases that are improving, early imaging is not needed. ²