Simultaneous versus consecutive administration of cervical traction and neural mobilization in patients with cervical radiculopathy: A randomized controlled trial

Background & Objective: Cervical traction and neural mobilization are frequently utilized in the management of cervical radiculopathy. However, there is a paucity of literature concerning the best order of application of these techniques. The aim of this study was to compare the effects of simultaneous and consecutive administration of cervical traction and neural mobilization on pain and function in cervical radiculopathy. Methods: Thirty patients were randomly assigned to two equal groups: consecutive (CON) and simultaneous (SIM) cervical traction and neural mobilization in this single-blind randomized controlled trial. The inclusion criteria comprised age 20-60 years, unilateral cervical radiculopathy ≥ 6 months, and positive upper limb neural tension tests of radial, median or ulnar nerve, and positive Spurling test. Outcome measurement tools were numeric pain rating scale, cervical goniometry, neck disability index, and short-form health survey. Data was analyzed with SPSS 23. Results: Significant improvement was evident in all parameters in CON after 1-week rehabilitation (P≤0.001 for seven of the ten variables). Similarly, all parameters showed significant improvement in SIM (P≤0.001 for all variables except mental component score of SF-12 with P<0.05). After rehabilitation, SIM was significantly better with respect to pain (P<0.05), flexion-extension mobility (P<0.001), and quality of life (P<0.01). No differences were found in other variables. Conclusion: Simultaneous use of cervical traction and neural mobilization resulted in significantly better outcomes with regards to pain, flexion-extension mobility, and quality of life. The two groups performed similarly on other outcome measures.