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A Surprising Approach to Treating Pinched Nerves

Patients who suffer from cervical radiculopathy, a condition in which a nerve is pinched within the cervical (neck) area of the spine, are typically treated with a variety of physical therapies designed to restore physical functions. Many of these therapies involve neck-specific treatments, cognitive-behavioral therapies, or anterior cervical decompression, which involves surgically removing the disc that's putting pressure on the spinal nerve.

While clinicians typically approach treating individuals with cervical radiculopathy with a variety of one of the above treatments, a new study explores what would happen if clinicians combined anterior surgery followed by physiotherapy.

In a randomized study conducted by researchers at several Swedish universities, sixty-three patients who suffered from radiculopathy and nerve root compression were randomized to receive either anterior cervical decompression and fusion (ACDF) in combination with physical therapy, or physical therapy alone. The objective of the study was to investigate if there were any differences in physical functional outcome. Researchers hoped that the results produced by this study would help clinicians form the best physiotherapy treatment for patients suffering from cervical radiculopathy.

After patients received their specific treatments, an independent examiner measured active range of neck motion, neck muscle endurance, and hand-related functioning over the course of two years.

The results showed little significant differences between patients who underwent ADCF with physiotherapy versus patients who underwent physiotherapy alone. In an encouraging result, both groups of patients demonstrated significant improvements in neck muscle endurance, manual dexterity, and right-hand grip strength.

While additional study is needed, the results are encouraging in terms of reducing the need for surgery As there is
little difference in results for patients who undergo ACDF and physiotherapy versus patients who undergo physiotherapy alone, this could make it possible for more patients to avoid the time, discomfort, and recovery associated with ACDF surgery.

Researchers have concluded that clinicians should undergo a structured physiotherapy program before resorting to placing the patient in ACDF surgery. This can reduce the need for ACDF intervention, which may reduce the cost of recovery for patients diagnosed with cervical radiculopathy.

As reported in the January 2009 issue of Eur Spine J.

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