Effects of Diaphragmatic Release Technique on Neck Pain, Range of Motion, and Chest Expansion in Patients With Cervical Radiculopathy

A group of researchers conducted a randomized controlled trial to compare the effects of neural mobilization and conservative treatment on pain, range of motion, and disability in patients with cervical radiculopathy. Eighty-eight patients from the Mayo Hospital, Lahore, were allocated into two groups after meeting the inclusion criteria. Cervical isometrics and a hot pack were applied to the control group. In contrast, the neural mobilization technique of median nerve sliding, along with cervical isometrics and a hot pack, was given to the experimental group over twelve sessions within four weeks. The numeric pain rating scale was used to measure pain intensity, the Neck Disability Index for functional status, and an inclinometer was used to measure the cervical range of motion. The neural mobilization technique was considered more effective for the treatment of median nerve bias and cervical radiculopathy as compared to the conservative treatment of isometrics in managing pain and disability. No difference was seen in the range of motion of the cervical spine in both groups.

A randomized placebo-controlled trial was conducted (2025) to determine the effect of immediate diaphragmatic relaxation on mobility and pain threshold in smartphone users with non-specific cervical spine pain. Thirty-eight women with neck pain were allocated into two groups. Neck range of motion was assessed by a goniometer, and pressure pain threshold by an algometer in participants who were assigned to the therapy group or a placebo group. The intervention consisted of a single manual relaxation of the diaphragm in the supine position. Comparison of pressure pain threshold showed significant differences in the therapy group.

Researchers carried out a pilot randomized controlled trial (2025) to ascertain the effects of manual release of the diaphragm on pain, disability, and function of the diaphragm in patients with chronic neck pain. A total of thirty-three patients were divided into a diaphragmatic manual release group and a placebo release group. A visual analog scale was used to evaluate the intensity of cervical pain, the level of disability with the neck disability index, and the CROM device for the measurement of range of motion. An ultrasound was used to measure the diaphragm excursion, and chest expansion was assessed with a tape ruler. The results of the study showed that the manual release of the diaphragm can have favorable outcomes for patients with neck pain.

A clinical researcher (2024) presented a case report of a sixty-four year old Japanese male diagnosed with bilateral diaphragmatic nerve paralysis secondary to cervical spondylosis. The blood gas analysis showed type 2 respiratory failure. Chest X-ray showed no movement of the diaphragm with respiration. MRI of the cervical spine was done, which showed stenosis at the level of C3-C4 and C4-C5. This case indicated the importance of considering diaphragmatic paralysis as a manifestation of cervical radiculopathy. If left untreated, the radiculopathy at the C3-C4 and C4-C5 levels can cause a time delay in the distal motor response of the phrenic nerve that would ultimately affect the function of the diaphragm, leading to respiratory problems A group of researchers conducted a prospective parallel randomized controlled study (2023) to assess the effect of diaphragmatic release on neck pain and chest expansion in patients with upper crossed syndrome. Thirty patients with upper crossed syndrome aged twenty to twenty-six years were divided into two equal groups. The control group received postural correction exercises. The experimental group received the aforementioned plan as well as the diaphragmatic release exercise. Pain was assessed by a visual analog scale, craniovertebral angle by the photogrammetric method, and chest expansion by tape measurement. The study demonstrated that the diaphragmatic release technique improved chest expansion and neck pain in the upper crossed syndrome.

A group of researchers (2023) performed a cross-sectional study to compare breathing patterns and diaphragmatic movement in patients with cervical radiculopathy and in the asymptomatic group. Twenty-five patients with unilateral cervical radiculopathy were placed in one group, and twenty-five asymptomatic individuals were placed in another group. Diaphragmatic motion was assessed with the help of manual assessment of respiratory motion (MARM), breathing pattern by fluoroscopy, cervical range of motion with the cervical range of motion device, and kinesiophobia by the Tampa scale of kinesiophobia. The results of this study showed an abnormal breathing pattern and a reduction in diaphragmatic excursion on the side of radiculopathy in patients with cervical radiculopathy.