C7 more comfortable with hand over head

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Any thoughts on why patients with C7 radiculopathy are more comfortable with their hand/arm raised over their head, while other radic levels do not get the same relief? Why this should help at all?
 
Any thoughts on why patients with C7 radiculopathy are more comfortable with their hand/arm raised over their head, while other radic levels do not get the same relief? Why this should help at all?

aka- the shoulder abduction relief sign

first patient I ever saw in residency came in with his arm held over his head similar to what you are describing. He had severe periscapular pain with the arm at the side. The attending didn't even examine him and said he had a radic. Sure enough....nice juicy disc on MRI.
 
Any thoughts on why patients with C7 radiculopathy are more comfortable with their hand/arm raised over their head, while other radic levels do not get the same relief? Why this should help at all?

I've always been taught that extending the arm increases dural tension and may make the impingement at the root level worse. Therefore abducting the arm and resting hand behind head decreases this dural tension relieving some of the symptoms.

As far as why C7 radics get better relief than other levels maybe that the C7 nerves travel the farthest and therefore can give up more slack when arm abducted and elbow flexed. Whereas the upper cervical levels end higher up on the arm, shoulder and neck and may require more shoulder abduction or just might be fixed in the axial portion of the body and no amount of arm abduction or elbow flexion will provide relief. Just thinking out loud...
 
I've always been taught that extending the arm increases dural tension and may make the impingement at the root level worse. Therefore abducting the arm and resting hand behind head decreases this dural tension relieving some of the symptoms.

As far as why C7 radics get better relief than other levels maybe that the C7 nerves travel the farthest and therefore can give up more slack when arm abducted and elbow flexed. Whereas the upper cervical levels end higher up on the arm, shoulder and neck and may require more shoulder abduction or just might be fixed in the axial portion of the body and no amount of arm abduction or elbow flexion will provide relief. Just thinking out loud...


by george, he's got it
 
C7 is longer. See attached jpg
 

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