Short-term effect of manual therapy on sensory features in patients with cervical radiculopathy: A randomized triple-blind experimental study

Abstract

Background & Purpose: Cervical radiculopathy is a neurological disorder, which commonly results from compression or inflammation of nerve root. Research has shown somatosensory changes with this condition as measured by quantitative sensory testing (QST). Few studies have examined the effectiveness of cervical manual therapy techniques in patients with cervical radiculopathy. Studies that investigated the effect of manual therapy on somatosensory changes in this group of patients are lacking. Therefore, the aim of study was to examine the short-term effects of manual therapy on the sensory features in patients with chronic cervical radiculopathy. Study design: Randomized triple-blind controlled study Methods: Twenty-eight participants with cervical radiculopathy were randomly allocated either to a group that received a cervical manual therapy technique and exercise (manual group) or to a group that received minimal superficial pressure and exercise (control group). Each participant received a total of 6 sessions for 3-5 weeks. Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), pressure pain threshold (PPT), heat/cold pain threshold (HPT/CPT), and active cervical range of motion (ROM) were measured at baseline, 5 minutes after the first and sixth session. The tested areas for PPT, HPT, and CPT were cervical spine, C7 dermatome on the hand, affected dermatome, and tibialis anterior. A mixed-model, two-way analysis of variance (ANOVA) and Bonferroni corrections were used to analyze the effects of treatment on the outcome measures. Results: Unlike the control group, manual therapy group showed statistically significant improvements with medium to large effect size from baseline to session 6 (week 3-5) in NPRS, NDI, PPT at the neck and C7 level at the hand, and active cervical ROM in extension, rotation and lateral flexion to the affected side (P<0>0.05). Conclusion: The results showed that cervical manual therapy for patients with cervical radiculopathy is effective for at least short-term in reducing pain intensity, functional limitations, and pressure pain sensitivity, as well as in improving cervical ROM for movements thought to decrease the size of intervertebral foramen.