Background: Cervical radiculopathy commonly coexists with trapezitis, and the combination can complicate presentation, as the myofascial component may mask an underlying radicular process and delay structured rehabilitation.
Case Presentation: A 53-year-old male driver with a several-year history of intermittent mild right-arm numbness presented with acute worsening of right trapezius pain radiating to the right upper limb, aggravated by sneezing and accompanied by paraesthesia, without motor or sensory deficit. Initial medical management produced little relief, and imaging with specialist review refined the diagnosis to right C5–C6 radiculopathy with trapezitis. He was referred for structured physiotherapy.
Intervention: Physiotherapy followed a two-phase progressive model - acute pain modulation followed by progressive rehabilitation and functional integration - delivered over 3–4 weeks, combining electrotherapy, manual therapy, neural mobilisation, therapeutic exercise, trigger-point and dry-needling techniques, and driving-specific postural and ergonomic retraining.
Result: Pain reduced progressively from severe (NPRS 8/10) at baseline to minimal (1–2/10) at final review, with parallel improvement in Neck Disability Index score from 37/50 (severe) to 9/50 (mild), alongside gains in cervical range of motion, neural tension testing, trapezius tenderness, paraesthesia frequency, and driving tolerance.
Conclusion: This case illustrates how a longstanding, previously subclinical numbness culminating in acute-on-chronic worsening, combined with trapezitis overlap, can complicate early recognition, and how a structured, phase-based physiotherapy programme can achieve substantial functional recovery within a short treatment window.