The Combined Efficacy of Neural Mobilization with Transcutaneous Electrical Nerve Stimulation (TENS) Versus Neural Mobilization alone for the Management of Cervical Radiculopathy

Abstract

Background: Cervical radiculopathy occurs annually in 85 out of 100,000 people. It is very disabling and interferes with the ADL of the patients. Many studies had shown the effectiveness of neural mobilization and TENS in reduction of pain and disability in patients with cervical Radiculopathy. But there are less documented studies that had shown the combined effect of neural mobilization and TENS and effectiveness of both over only neural mobilization in patients with cervical radiculopathy. Methods: 30 male and female subjects were assessed as cervical radiculopathy and selected for the study. This includes unilateral cervical radiculopathy. They were categorized randomly into two groups as group receiving neural mobilization and TENS (experimental group I) and group receiving only neural mobilization (experimental group II) with 15 patients in each group. Assessment was taken using VAS and NDI prior to treatment. Treatment was continued for 14 days and at the end of 14 days patients were reassessed using the same scales.Results: Group 1 receiving both the treatments had shown more significant reduction in pain and disability compared to Group 2 receiving only neural mobilization after 14 days of treatment.Conclusion: Both neural mobilization and TENS are effective in reduction of pain and disability in patients with cervical radiculopathy. And when compared, combined treatment is more effective than only neural mobilization.

The Effectiveness Of Routine Physiotherapy With And Without Neuromobilization In Patients With Shoulder Impingement Syndrome On Pain And Functional Disability; A Randomized Control Clinical Trial

“…The results of our study are also in agreement with Pritam Deka,who explored that neuromobilization is effective treatment for pain and when neuromobilization and TENS combined was used then more effective results were found on cervical radiculopathy (26).…”

The effectiveness of routine physiotherapy with and without neuromobilization on pain and functional disability in patients with shoulder impingement syndrome; a randomized control clinical trial

“…So, it was greater betterment in the experimental group as compared to the care group. The results of a study by Pritam Deka revealed that NM has fruitful effects in mitigating the pain by restoring neurodynamics properties in upper limb [ 24 ]. Robert J Nee et al study has found immediate relief of pain in arm with no evidence of harmful effects and future researches are recommended to check long term effects of NM on pain [ 25 ].…”

“…The results of current study were also similar with Pritam Deka, who explored that neuromobilization was effective treatment for pain. When neurombilization combined with TENS were used, more effective results were found on cervical radiculopathy [ 24 ]. The current study determined the results to be similar to those of Matocha MA et al who found that pain intensity decreased weekly basis as decreased in present study on 5th and 11th week but further research is needed to help clinicians in making education decision for implementing these techniques in to clinical practice [ 20 ].…”

Transcutaneous electrical stimulation in neck pain: A systematic review and meta‐analysis

“…Thirteen studies assessed the effects of ES combined with other intervention versus other intervention on pain intensity at rest immediately post-treatment (Albornoz-Cabello et al, 2019;Ardic et al, 2002;Azatcam et al, 2017;Chiu et al, 2005;Deka et al, 2016;Dissanayaka et al, 2016;Hendriks & Horgan, 1996;Hou et al, 2002;Kim et al, 2014;Liu et al, 2020;Nordemar & Thörner, 1981; ITT, intention-to-treat. Prabhakar & Ramteke, 2011;Tanrikut et al, 2003).…”

“…Prabhakar & Ramteke, 2011;Tanrikut et al, 2003). One meta-analysis with nine trials provided evidence of moderate quality (downgraded by inconsistency) showing that ES combined with other intervention significantly decreases pain intensity compared to other intervention immediately post-treatment (SMD −0.97; 95% CI −1.54 to −0.40) (Albornoz-Cabello et al, 2019;Ardic et al, 2002;Azatcam et al, 2017;Chiu et al, 2005;Deka et al, 2016;Hou et al, 2002;Kim et al, 2014;Liu et al, 2020;Nordemar & Thörner, 1981). Subgroup analysis according to type of NP and duration of symptoms showed significant pain reduction in NP (undetermined time) and radiculopathy (Figure 4a, Table 4).…”