Manual Therapy as a Management of Cervical Radiculopathy: A Systematic Review

Borrella-Andrés, Sergio; Marqués-García, Isabel; Lucha-López, María Orosia; Fanlo-Mazas, Pablo; Hernández-Secorún, Mar; Pérez‐Bellmunt, Albert; Tricás-Moreno, José Miguel; Hidalgo-García, César

doi:10.1155/2021/9936981

Cited by 22 publications

(17 citation statements)

References 48 publications

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“…There are several mechanisms whereby the treatment provided in the present case could have led to a reduction in symptoms. We suggest that the cervical spine mobilizations may have alleviated radicular components of the patient’s neck pain, in accordance with a recent systematic review that found manual therapies were effective in reducing cervical radiculopathy [ 36 ]. However, this would only partially explain the improvement from her spectrum of symptoms (eg, not the broader pattern of neurologic deficits).…”

Section: Discussionsupporting

confidence: 86%

Neck pain and Headache Complicated by Persistent Syringomyelia After Foramen Magnum Decompression for Chiari I Malformation: Improvement with Multimodal Chiropractic Therapies

Chu¹,

Trager

Ng³

et al. 2022

Am J Case Rep

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Patient: Female, 62-year-old Final Diagnosis: Cervical spondylosis • syringomyelia Symptoms: Headache • neck pain • upper extremity numbness and weakness Medication: — Clinical Procedure: Exercises • soft tissue manipulation • spinal mobilization • therapeutic ultrasound Specialty: Chiropractic Objective: Rare disease Background: Patients with Arnold-Chiari Malformation I (CM-I) treated with foramen magnum decompression (FMD) can have ongoing neck pain, headaches, and other symptoms complicated by persistent syringomyelia, yet there is little research regarding treatment of these symptoms. Case Report: A 62-year-old woman with a history of residual syringomyelia following FMD and ventriculoperitoneal shunt for CM-I presented to a chiropractor with progressively worsening neck pain, occipital headache, upper extremity numbness and weakness, and gait abnormality, with a World Health Organization Quality of Life score (WHO-QOL) of 52%. Symptoms were improved by FMD 16 years prior, then progressively worsened, and had resisted other forms of treatment, including exercises, acupuncture, and medications. Examination by the chiropractor revealed upper extremity neurologic deficits, including grip strength. The chiropractor ordered whole spine magnetic resonance imaging, which demonstrated a persistent cervico-thoracic syrinx and findings of cervical spondylosis, and treated the patient using a multimodal approach, with gentle cervical spine mobilization, soft tissue manipulation, and core and finger muscle rehabilitative exercises. The patient responded positively, and at the 6-month follow-up her WHO-QOL score was 80%, her grip strength and forward head position had improved, and she was now able to eat using chopsticks. Conclusions: This case highlights a patient with neck pain, headaches, and persistent syringomyelia after FMD for CM-I who improved following multimodal chiropractic and rehabilitative therapies. Given the limited, low-level evidence for these interventions in patients with persistent symptoms and syringomyelia after FMD, these therapies cannot be broadly recommended, yet could be considered on a case-by-case basis.

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Section: Discussionsupporting

confidence: 86%

Neck pain and Headache Complicated by Persistent Syringomyelia After Foramen Magnum Decompression for Chiari I Malformation: Improvement with Multimodal Chiropractic Therapies

Chu¹,

Trager

Ng³

et al. 2022

Am J Case Rep

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“…ND improves the mechanical function of nerve structures in terms of tension, sliding, and compression which can affect intraneural microcirculation. ND affects the mechanical function of peripheral nerves and changes in the mechanical function of these nerves have a direct impact on physiological changes in the nervous structure as of affecting the improvement of pain levels and functional abilities (Borrella-Andrés et al, 2021;Mayank Manojbhai Raval & Shweta Rameshbhai Rakholiya, 2022;Nugraha et al, 2019). This is also supported by a previous meta-analysis which stated that ND can reduce pain (mean difference, -1.89; 95% CI: -3.14, -0.64; p<0.001) in nerve-related neck and arm pain (Basson et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

The Addition Of Bilateral Neurodynamics In Ultrasound Therapy And Manual Traction Intervention In Cervical Radiculopathy

Nugraha

Kinandana

2022

j.keterapian.fis.

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Background: Cervical radiculopathy is a condition that characterized by pain and/or sensorimotor deficits caused by compression of one or more cervical nerve roots. The aim of this case series is to serve as a preliminary study to determine the effectiveness of adding bilateral neurodynamics to the intervention of ultrasound therapy and manual traction in cervical radiculopathy. Methods: The research writing method used CARE (CAseREport) guidelines, which consisted of: introduction, patient information, clinical findings, timeline, diagnostic assessment, therapeutic intervention, follow-up and outcome, and discussion. The measuring instrument used in this study was the Visual Analogue Scale (VAS) in assessing tension pain when given neurodynamics and neck disabilities using the Indonesian version of the Neck Disability Index (NDI). The intervention was carried out 12 times (3 times a week for 4 weeks) and a follow-up was done at week 5. Results: The results showed that there was an improvement in the score of neck pain and disability in the 2 patients both at post-test and at follow-up. Conclusion: Based on these findings, it can be concluded that the application of additional bilateral neurodynamics in the intervention of ultrasound therapy and manual traction can help reduce pain and improve neck disability.

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“…CSR incidence increases with age and has an estimated frequency of 0.35% in the fifth to sixth decade of life [ 2 ]. Recently, multiple systematic literature reviews have been published seeking to understand the complexities of CSM and its natural history, conservative management strategies, and the need for surgical interventions [ 2 , 8 , 9 , 10 , 11 , 12 , 13 ]. For patients with intractable pain and with motor loss of less than three out of five, surgical intervention is warranted [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…For patients with intractable pain and with motor loss of less than three out of five, surgical intervention is warranted [ 2 ]. However, in comparison between conservative and surgical management trials, the long-term outcomes at 1–2 years generally show conservative care to be equally effective for less severe CSM patients [ 2 , 8 , 9 , 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Cervical Lordosis Rehabilitation for Nerve Root Function and Pain in Cervical Spondylotic Radiculopathy: A Randomized Trial with 2-Year Follow-Up

Moustafa

Diab

Harrison

2022

JCM

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Sagittal cervical alignment is a clinically related feature in patients suffering from chronic cervical spondylotic radiculopathy (CSR). We designed this randomized trial to explore the effects of cervical lordosis (CL) correction in thirty chronic lower CSR patients with CL < 20°. Patients were assigned randomly into two equal groups, study (SG) and control (CG). Both groups received neck stretching and exercises and infrared radiation; additionally, the SG received cervical extension traction. Treatments were applied 3× per week for 10 weeks after which groups were followed for 3 months and 2 years. The amplitude of dermatomal somatosensory evoked potentials (DSSEPS), CL C2–C7, and pain scales (NRS) were measured. The SG had an increase in CL post-treatment (p < 0.0001), this was maintained at 3 months and 2 years. No statistical improvement in CL was found for the CG. A significant reduction in NRS for SG after 10 weeks of treatment with non-significant loss of change at 3 months and continued improvement at 2 years was found. CG had less significant improvement in post-treatment NRS; the 3-month and 2-year measures revealed significant worsening in NRS. An inverse linear correlation between increased CL and NRS was found (r = −0.49; p = 0.005) for both groups initially and maintained in SG at the final 2-year follow-up (r = −0.6; p = 0.01). At 10 weeks, we found significant improvements in DSSEPS for both groups (p < 0.0001). We identified a linear correlation between initial DSSEPs and CL for both groups (p < 0.0001), maintained only in the SG at the final follow-up for all levels (p < 0.0001). Improved CL in the SG correlated with significant improvements in nerve root function and pain rating in patients with CSR at short and long-term follow-up. These observed effects indicate that clinicians involved in the treatment of patients with symptoms of cervical degenerative disorders should add sagittal curve correction to their armamentarium of rehabilitation procedures for relevant patient populations.

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Manual Therapy as a Management of Cervical Radiculopathy: A Systematic Review

Cited by 22 publications

References 48 publications

Neck pain and Headache Complicated by Persistent Syringomyelia After Foramen Magnum Decompression for Chiari I Malformation: Improvement with Multimodal Chiropractic Therapies

Neck pain and Headache Complicated by Persistent Syringomyelia After Foramen Magnum Decompression for Chiari I Malformation: Improvement with Multimodal Chiropractic Therapies

The Addition Of Bilateral Neurodynamics In Ultrasound Therapy And Manual Traction Intervention In Cervical Radiculopathy

The Efficacy of Cervical Lordosis Rehabilitation for Nerve Root Function and Pain in Cervical Spondylotic Radiculopathy: A Randomized Trial with 2-Year Follow-Up

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