In which cases of cervical radiculopathy should I refer a patient to a

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Refer a patient with cervical radiculopathy to a specialist for further evaluation or intervention if:

Symptoms have remained stable for 6 weeks or more but pain is not controlled with analgesics.
Symptoms are disabling.
Any of the following neurological signs or risk factors are present: age under 20 years, gait disturbance, clumsy or weak hands or legs, brisk deep tendon reflexes (especially triceps and lower limbs), extensor plantar responses, or new-onset disturbance of bladder or bowel function.

Do not routinely refer patients with stable symptoms for 6 weeks or more if none of the above apply.

Reference: NICE guideline NG127 - Suspected neurological conditions: recognition and referral .

In which cases of cervical radiculopathy should I refer a patient to a specialist for further evaluation or intervention?