Effect of Cervical Traction With Neural Mobilization on Nerve Root Functions in Cervical Radiculopathy Patients

Effect of Cervical Traction From Different Angles With Neural Mobilization on Nerve Root Functions in Cervical Radiculopathy Patients

This study will be conducted to examine

1. The efficacy of mechanical traction from decompression angles combined with neural mobilization on the H reflex of flexor carpi radialis.
2. The efficacy of mechanical traction from decompression angles combined with neural mobilization on ultrasonography changes.
3. The efficacy of mechanical traction from decompression angles with neural mobilization has a Numeric Pain Rating Scale.
4. The efficacy of mechanical traction from decompression angles combined with neural mobilization on Neck Disability Index.

Cervical radiculopathy is a condition characterized by pain, sensory and motor impairments, and slowed reflexes caused by the compression of cervical nerve roots, often stemming from cervical disc herniation. The etiology includes mechanical compression and chemical irritation, commonly due to foraminal stenosis. Cervical radiculopathy pain is a combination of nociceptive and neuropathic components, with various conservative treatments available, including immobilization and physical therapy, although evidence for their efficacy is limited. Neural mobilization especially when combined with cervical traction, shows promise in alleviating nerve-related pain and enhancing treatment adaptability. Techniques involving specific joint movements can enhance foraminal dimensions, thereby affecting nerve tension and circulation. This study uniquely examines the effects of head positions on foraminal opening and clinical outcomes, including H reflex and ultrasonography changes.

Inclusion Criteria:

1. The patient's age will be ranged from 30 to 45 years old for both genders.
2. The patient's with unilateral C5-6 and C6-7 (posterior lateral disc protrusion) confirmed by T 2, axial view of magnetic resonance imaging
3. The patient's symptoms more than 3 months and positive provocative test for cervical radiculopathy (Spurling's test, shoulder abduction test, neck distraction test, and upper limb tension test 1 (Median nerve).
4. Sensory, reflex, and/ or motor changes in the upper limb

Exclusion Criteria:

1. History of surgical procedures for pathologies giving rise to neck pain or carpal tunnel syndrome
2. Clinical signs or symptoms of medical "red flags" (infection, cancer, and cardiac involvement).
3. Patients with neck pain for signs and symptoms of serious pathology, including suspected arterial insufficiency, upper cervical ligamentous insufficiency, unexplained cranial nerve dysfunction, and fracture.
4. Systemic diseases such as autoimmune and metabolic diseases.
5. History of steroid injection.
6. Complete loss of sensation along the involved nerve root.
7. bilateral radiating upper extremity
8. Diabetic polyneuropathy.