When a nerve becomes pinched or inflamed in the neck, pain or numbness can extend from the neck into the shoulder, arm or hand. If the problem becomes severe, weakness may develop. As with sciatica in the lower back there are a number of possible causes. These include misalignment of a neck vertebrae, bulging or herniation of a disk or arthritic spurs irritating a nerve. A careful and thorough history and examination, which may include x-rays or MR imaging, is necessary to determine the cause of the problem before any type of treatment is started. Treatment may include spinal manipulation to restore joint motion and reduce pressure, trigger point therapy for muscular spasm and possibly neck strengthening exercises. With this regimen the vast majority of patients treated over the last thirty years have made good recoveries and returned to normal activities.