Transverse oscillatory pressure in management of cervical radiculopathy: A randomised controlled study

Abstract

Background: Cervical radiculopathy is an important subgroup of neck disorders causing severe pain and disability. Objectives: The study assessed the effect of transverse oscillatory pressure (TOP) on pain intensity and functional disability of patients with cervical radiculopathy. Methods: Twenty-six individuals with unilateral radiating neck pain were randomly allocated into Group A (8 males and 5 females) and Group B (6 males and 7 females). Participants in the two groups received kneading massage, cryotherapy, and active isometric exercises to the posterior paraspinal muscles, trapezuis, and sternomastoid muscles. TOP was administered to Group A, whereas Group B served as control. Treatment was applied three times per week for 4 weeks, making 12 treatment sessions for each participant. Visual analogue scale and Neck Disability Index were used to assess pain intensity and neck disability, respectively, at baseline, 2 weeks, and 4 weeks. Data were analysed using repeated-measures analysis of variance. Results: There was a significant improvement in pain intensity and neck functional disability of patients between baseline, 2 nd week, and 4 th week of treatment sessions in Groups A and B ( p < 0.05). There was a significant reduction in pain intensity in Group A ( f = 7.08, p < 0.05) at the 2 nd week and 4 th week compared with Group B. Conclusion: It can be concluded that TOP reduces pain faster in patients with cervical radiculopathy.

Effect of Vertical Oscillatory Pressure on Pain Intensity and Respiratory Variables in Patients with Cervical Spondylosis

“…It has been reported that spinal manual therapy such as VOP may excite polymodal nociceptors and wide dynamic range neurons that stimulate the release of opioid peptides such as enkephalin and morphins (Egwu et al, 2012). These opioid peptides in the central nervous system are proposed to be a factor in the analgesic effect of VOP (Ojoawo et al, 2016). Vertical oscillatory pressure tend to produce emotions driven by the aversive primary motive system which according to Egwu et al (2012) activates the amygdala and periaquiductal gray (PAG) area which release enkephalins and endorphins to modulate pain.…”

“…VOP is observed to be a painful procedure capable of causing anxiety which may lead to changes in respiratory mechanism (Ojoawo et al, 2016). Stress perceived by the patient during the application of a manual therapy treatment technique may account for the reported findings of sympathoexcitation and hypoalgesia immediately after its application (Egwu et al, 2012).…”

“…Cervical spondylosis or cervical osteoarthritis is a progressive degeneration of the intervertebral disc in the cervical region leading to changes in the surrounding structures especially the bones and the ligaments. It has characteristics of bony outgrowths, nerve root compression, paraesthesia, pain and/or muscle weakness (Ojoawo et al, 2016). It is noted that the degenerative changes in the joints lead to inflammation and collagen deposits on soft tissues in and around subsequently causing muscle spasm, reduced electrical activities in the nerves and loss of function in the spine and/or muscles (Egwu, et al, 2012).…”

“…However, researchers and clinicians differ in their schools of thought on causes of back pain and the therapeutic treatment modalities to be chosen (Egwu et al, 2012). They chose strengthening exercises and spinal manual therapy (SMT) as current therapeutic modalities which have been documented to be of greater effectiveness (Egwu et al, 2012).The oscillatory techniques are gentle forms of manipulation and include vertical oscillatory pressure (VOP), transverse oscillatory pressure (TOP) etc (Ojoawo et al, 2016). 75% of candidates for manipulation can be helped with the SMT techniques especially VOP which is the simplest and most versatile (Egwu et al, 2012).…”

“…Vital capacity is the maximum volume of air that can be forcefully expired into a spirometer after a maximal inspiration (Azevedo et al, 2012). Many studies have examined the effects of VOP on pain intensity of patients with cervical spondylosis (Ojoawo et al, 2016;Ojoawo et al, 2013). However, studies on the effect of VOP, a technique of spinal manual therapy on respiratory parameters of patients with cervical spondylosis are scarce.…”