Effect of McKenzie Exercises and Neural Mobilization Technique combined with Intermittent Cervical Traction in Patients with Cervical Radiculopathy

Cervical Radiculopathy is a common condition characterized by pain, numbness, tingling and/or heaviness in arm as symptoms. The radiating pain is usually present  along the distribution of a cervical nerve root. The average annual incidence rate of cervical radiculopathy is 83 per 100000 of population, with an increased prevalence occurring in the 5th decade of life (Dhuriya et al., 2021). The most commonly affected level is C5-C6 with 86% of affected population and the C6-C7 level is the next most frequently affected site. The involvement of the 8th cervical nerve root by a herniated C7-T1 disc produces a significant weakness of the intrinsic musculature of the hand which results in significant loss of fine movements of hand (Mohamed Faisal et al., 2012). The muscle weakness produced in one segment of the affected upper limb, would contribute to a generalized muscle weakness and consequently reduced hand strength (Nair et al., 2017). One of the lesser known impact of cervical spondylosis is on cervical joint position sense. As cervical spondylosis is a degenerative condition it can adversely affect the proprioceptive mechanism that regulate the neck position and movement (Alahmari and Reddy, 2024). The most common treatment for cervical radiculopathy is mechanical traction which is used to decompress the nerve root by separating the cervical segments through long-axis traction (Sarfaraj, 2018). Neural mobilization and McKenzie techniques when given with mechanical traction have improved pain and disability but there effects on hand grip and cervical proprioception need to explored in patients with cervical radiculopathy. As, neural mobilization mobilizes nerve tissue which results in reduced intrinsic pressure of the neural tissue and can re-establish the neural biomechanics such as elasticity etc. (Mohammed et al., 2019). The McKenzie techniques are used for treatment of the postural, dysfunctional and derangement syndromes in neck region. They have been proven to be effective in pain, neck disability and cervical muscle endurance in cervical radiculopathy individuals (Darji and Soni, 2022). Cervical radiculopathy is a common neuromusculo-skeletal disorder and presents great challenges for individuals with cervical spondylosis. There are paucity of literature on effect of McKenzie exercises and neural mobilization combined with intermittent cervical traction (ICT) on various parameters in cervical radiculopathy. Therefore, the current study is designed to compare the effectiveness of McKenzie technique and neural mobilization when combined to intermittent cervical traction on pain, neck disability, hand grip and neck proprioception in patients with cervical radiculopathy.