Muscle Energy Versus Mulligan Techniques in Treating Patients With Cervical Spondylosis

Cervical spondylosis (CS) is a highly prevalent age-related condition (95%), that affects the joints and discs of the cervical spine. By age 65, nearly all individuals experience some degree of degeneration, characterized by disc breakdown and enlarged facet joints. While aging is the primary cause, injuries can accelerate this process in younger populations.

Significance of the Study Age-related degenerative spinal changes are almost widespread. Population-based studies have shown that approximately 80 to 90% of people have disk degeneration on magnetic resonance imaging (MRI) by the age of 50 years.

A global burden review estimates that over 300 million people worldwide had mechanical neck pain lasting at least 3 months in 2015.

Clinical features of spondylosis are more common in men than in women, with a peak incidence between the ages of 40 and 60 years for both men and women.

Cervical spondylosis commonly affects the middle and lower cervical vertebrae (C5-C6 and C6-C7), although higher levels may also be involved. Neck pain is the most prominent symptom. CS can affect all cervical components (i.e., the spinal cord, spinal vasculature, and nerve roots). Cervical spondylosis Symptoms include cervical instability (abnormal movement or laxity between vertebrae). This instability can lead to various symptoms such as neck pain, muscle imbalance between cervical and shoulder girdle muscles (weakness in cervical flexors, lower trapezius, and anterior serratus; tightness in the upper trapezius, scapular lift, and pectoralis major), disc herniation and osteophyte formation. These can compromise proprioception (accurate sensory feedback) and limit neck mobility, significantly impacting function and daily activities.