- Duration
- Acute Triage (Hours 0-72) | Integrated Rehabilitation (Weeks 2-8)
- Frequency
- Care combines Cox® cervical decompression with immediate targeted brachial plexus nerve gliding and scapular stabilization.
- Equipment
- Cox® Flexion-Distraction Cervical Headpiece, Cervical Radiculopathy Spurling Target, Upper Extremity Nerve Glide Board, Grip Dynamometer.
- 1.1. Neuromuscular Cervical & Radicular TriageWe isolate dermatomal paresthesia down the arm, test myotomal weakness (pushing/lifting), check deep tendon reflexes, and perform Spurling's maneuver.
- 2.2. Cervical Cox® Decompression ('Opening the Window')Dr. Paul Sta. Juana, DC applies hands-on Cox® cervical decompression to drop intradiscal pressure, open the intervertebral foramina, and un-pinch the cervical nerve root.
- 3.3. Immediate Targeted Brachial Plexus Physical TherapyWhile nerve root pressure is relieved, Liza Sta. Juana, PT guides targeted nerve gliding exercises, scapular retractor activation, and neck-to-arm movement re-education.
- 4.4. Functional Capacity & Upper Quarter Load TestingWe re-test overhead reaching, push/pull strength, typing endurance, and sleep continuity under direct 1-on-1 supervision.
← Back to Injury Resource Center
Arm Heavy, Weak, or Tingling Down into Your Fingers?
Experience The Open Window Method: Cox® Cervical Decompression + Immediate Physical Therapy for Cervical Radiculopathy under one roof in Alamo, TX.
Call (956) 591-8589 To ScheduleEducational Disclaimer: This publication is for health education purposes only and does not constitute formal medical advice or guaranteed outcomes. Individual results vary. Direct clinical examination is required to determine eligibility for care.
The Neck Problem That Shows Up in the Arm
It is one of the most confusing clinical presentations we see at our Alamo facility: a patient walks in rubbing an intense "muscle knot" behind their shoulder blade, complaining that their triceps feel heavy, or shaking out their hand because their thumb and index finger feel numb.
They spent weeks digging lacrosse balls into their upper back, getting deep-tissue shoulder massages, or wearing arm braces in McAllen, Pharr, or Edinburg—yet the moment they try to push open a heavy door, reach overhead, or type for 10 minutes, the burning arm pain returns.
The reason those local shoulder and arm treatments fail is straightforward: the arm is simply the messenger. The starting point is a pinched nerve root in your neck. This condition is known medically as Cervical Radiculopathy.
"Your Arm May Not Be the Starting Point"
Your cervical spine contains seven vertebrae that protect critical nerve roots branching out into your shoulder blade, arm, forearm, hand, and fingertips. When a disc herniates, a facet joint degenerates, or whiplash trauma narrows the exit canal (*intervertebral foramen*), the nerve root gets compressed.
"That heavy feeling in your arm may not be an arm problem. We see this with people who feel tingling in the fingers, pain near the shoulder blade, or weakness when they try to lift, push, or grip. Do not keep treating it like a tight shoulder if the numbness or weakness keeps coming back. Sometimes the arm is where the warning signal shows up, but the source is a nerve being irritated near the neck. The arm is the messenger. The neck is the starting point."
Common Symptoms of Cervical Radiculopathy
Depending on which specific cervical nerve root (C5, C6, C7, or C8) is compressed in your neck, symptoms manifest down different neurological highways:
- Scapular "Knot" Pain: A deep, burning ache along the inside border of your shoulder blade that massage cannot release.
- Radiating Arm Pain: A sharp, electric shock or dull ache traveling down your biceps, triceps, or forearm.
- Digital Tingling & Numbness: Pins-and-needles paresthesia mapping into your thumb and index finger (C6) or middle finger (C7).
- Motor Weakness: Sudden muscle collapse or shaking when attempting floor push-ups, overhead pressing, or carrying a heavy box.
The Open Window Method: Why Doing PT Immediately After Decompression Is Best
At South Texas Accident & Injury (located at 505 W Business Hwy 83 Ste 7 in Alamo, TX), we treat Cervical Radiculopathy using The Open Window Method—combining certified Cox® cervical decompression with immediate physical therapy nerve gliding:
CERVICAL COX® DECOMPRESSION → OPENS MOVEMENT WINDOW → IMMEDIATE PHYSICAL THERAPY NERVE GLIDING
Step 1: Certified Cox® Cervical Decompression ("Opening the Window")
Dr. Paul Sta. Juana, DC conducts gentle, doctor-guided Cox® Flexion-Distraction on the cervical spine. This rhythmic axial distraction lowers intradiscal pressure, opens the nerve root exit canal by up to 28%, and physically un-pinches the compressed nerve root—creating an immediate, pain-free "movement window."
Step 2: Immediate Neuromuscular Physical Therapy ("Locking In Recovery")
While your cervical nerve root is decompressed and pain-free, you step directly into our physical therapy bay under Liza Sta. Juana, PT. We guide you through upper extremity nerve gliding drills, deep cervical flexor activation, and scapular retractor strengthening—training your nervous system and posture muscles to keep that nerve window open permanently under daily load.
Un-Pinch the Nerve. Restore the Arm.
When a pinched cervical nerve is ignored, motor weakness progresses and arm muscles begin to atrophy. We combine certified Cox® cervical decompression with targeted nerve gliding physical therapy to protect nerve health.
Treating the Symptom
- ✕ Massaging the shoulder blade without evaluating the neck
- ✕ Ignoring arm weakness and digital finger tingling
- ✕ Allowing cervical nerve root compression to worsen over time
The Open Window Method
- ✓ Cox® cervical decompression opens the nerve root window
- ✓ Immediate 1-on-1 nerve gliding & arm strength PT
- ✓ Co-managed DC + PT care under $0 out-of-pocket LOP liens
Serving Cervical Radiculopathy Patients Across the Rio Grande Valley
Located centrally at 505 W Business Hwy 83 Ste 7 in Alamo, TX 78516, our facility provides quick access off I-2 / US-83 for residents across the RGV:
Alamo • McAllen • Pharr • San Juan • Edinburg • Mission • Weslaco • Donna
Frequently Asked Questions
How do I know if my arm pain is a shoulder problem or Cervical Radiculopathy?
If moving your neck, turning your head, or looking up reproduces the electric pain, tingling, or heaviness down your arm, the source is likely a pinched nerve root in your neck. Primary shoulder problems (like rotator cuff tears) typically hurt strictly when raising the arm, without causing numbness in your fingers. Our clinical team performs specific orthopedic and neurological tests during your exam to confirm the exact source.
Why is physical therapy performed immediately after Cox® cervical decompression?
Timing is everything. Cox® cervical decompression opens the intervertebral exit canal and un-pinches the spinal nerve root, creating an "open window." Performing physical therapy immediately afterward retrains the brachial plexus nerves to glide smoothly and strengthens your scapular stabilization muscles to maintain that alignment.
Do you accept car accident (LOP) attorney liens for neck and arm injuries?
Yes. If your cervical radiculopathy occurred during a car accident (such as severe whiplash impact), we accept cases under a Letter of Protection (LOP) with $0 out-of-pocket cost to you, working alongside your attorney while providing defense-grade medical records.




