Which is better to decompress the nerve roots in cervical radiculopathy: stretching or traction from foraminal opening position?

Abstract

IntroductionCervical traction has long been used to relieve compression of nerve roots caused by intervertebral discs. Yet, there is lack of knowledge on comparing the effect of traction decompression with neck muscle stretching in patients with cervical radiculopathy (CR). This study investigated the effect of different angles of decompression on the flexor carpi radialis H-reflex, Neck Disability Index (NDI), and pain level (determined with the visual analogue scale) in patients with CR and compared the results with neck muscle stretching.MethodsOverall, 58 patients with CR were randomly assigned to 4 groups. Group A received a stretching protocol to the cervical musculature. Group B was treated with traction therapy from neutral position with rope angle 0°. Group C underwent traction therapy from 30° lateral bending toward the side opposite to radiculopathy. Group D was managed with traction from 15° flexion with 30° lateral bending to the side opposite to radiculopathy and 15° rotation toward the side of radiculopathy. All participants were assessed before and after 6 weeks of treatment.ResultsMixed design MANOVA revealed that the H-reflex increased significantly (<i>p</i> < 0.05) after treatment in groups A, B, and D. However, it increased non-significantly in patients within group C. NDI and pain scores decreased significantly after treatment in all tested groups.ConclusionsDecompression traction from retracted neutral position with 0° rope angle and foraminal opening directions is as effective as stretching of ipsilateral neck muscles in enhancing nerve root decompression and reducing pain in patients with CR.