EFFECT OF NEURAL TISSUE MOBILIZATION VERSUS MANUAL CERVICAL TRACTION COMBINED WITH STRENGTHENING EXERCISE ON PAIN INTENSITY IN CERVICAL RADICULOPATHY: A COMPARATIVE STUDY

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Background: Cervical radiculopathy is a condition that occurs when a cervical nerve root is compressed or
irritated, and is the most common cause of neck and radiating arm pain in working age and older individuals.
Although pain is the predominant reason patients seek treatment, there s still no clear consensus on whether
neurodynamic therapy or conventional joint based treatment, when combined with active strengthening
exercises offers greater immediate pain relief.
Objective: i) To evaluate the effectiveness of manual cervical traction combined with a specific
strengthening programme reducing pain intensity in cervical radiculopathy; ii) To assess the effectiveness
of neural tissue mobilization combined with the same strengthening programme reducing pain intensity in
cervical radiculopathy iii) To compare the two approaches for their effect on pain reduction at 6 weeks.
Methods: Sixty patients with cervical radiculopathy, diagnosed with MRI and positive neural provocation
testing, were randomized equally into two groups. Group A (n=30) given manual cervical traction combined
with strengthening exercise and Group B (n=30) given neural tissue mobilization combined with
strengthening exercise. Treatment was given five days a week for a period of six weeks. The Numeric Pain
Rating Scale (NPRS) was used to determine pain at baseline and at 6 weeks.
Results: There was a statistically significant decrease in NPRS score within each group (p<0.05). Group A
improved from a mean of 7.03±0.76 to 6.03±0.70, while Group B improved from 7.03±0.76 to 3.57±0.82.
The difference between the groups at 6 weeks was in favour of Group B (mean difference 2.46 points, t=3.05,
df=58, p=0.005).
Conclusion: Both neural tissue mobilization and strengthening exercise were clinically effective; however,
neural tissue mobilization with strengthening exercise resulted in a significant decrease in pain intensity
compared with cervical manual traction with strengthening exercise in patients with cervical radiculopathy.