Manual Physical Therapy Targeting the Thoracic Spine to Promote Centralization for Patients With Cervical Radiculopathy: A Case Series

Abstract

Background Interventions targeting the thoracic spine may be underutilized when managing patients with cervical radiculopathy. This case series describes the management of 3 patients with neck pain with radiating symptoms who experienced centralization of symptoms in response to interventions targeting the thoracic spine. Case Presentation The 3 patients presented to physical therapy with signs and symptoms suggesting cervical radiculopathy involving the lower cervical segments that initially peripheralized during repeated cervical retraction. A test-retest management approach guided the selection of interventions targeting the thoracic spinal region. Outcome and Follow-Up After attending an average of 4 sessions over 4.5 weeks, each patient demonstrated clinically significant improvements in pain and self-reported disability at discharge and 6 months later. Discussion This case series supports the use of interventions targeting the thoracic spine to promote centralization for a subgroup of patients with lower cervical radiculopathy symptoms that peripheralized with cervical retraction. JOSPT Cases 2021;1(4):222–230. doi:10.2519/josptcases.2021.10575