The effectiveness of conservative treatment for patients with cervical radiculopathy

The goal of this systematic review was to assess the efficacy of conservative treatments for patients with cervical radiculopathy, a term used to describe neck pain associated with pain radiating into the arm. Not much is known about the effectiveness of conservative treatment for patients with cervical radiculopathy. The authors electronically searched the Cochrane Controlled Trials Register, MEDLINE, EMBASE, and CINAHL for randomized clinical trials. Conservative therapies consisted of physiotherapy, collar, traction etc. Two authors independently assessed the risk of bias using the criteria recommended by the Cochrane Back Review Group and extracted the data. If studies were clinically homogenous, a meta-analysis was performed. The overall quality of the body of evidence was evaluated using the GRADE method. Fifteen articles were included that corresponded to 11 studies. Two studies scored low risk of bias. There is low-level evidence that a collar is no more effective than physiotherapy at short-term follow-up and very low-level evidence that a collar is no more effective than traction. There is low-level evidence that traction is no more effective than placebo traction and very low level-evidence that intermittent traction is no more effective than continuous traction.

 

Based on the level to very low-level evidence, no single intervention appears to be superior or consistently more effective than other interventions. Regardless of the intervention assignment, patients seem to improve over time, suggesting a favorable natural course. Use of a collar and physiotherapy show promising results at short-term follow-up.

Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.

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