Background: Cervical radiculopathy is a common condition characterized by nerve root compression, leading

combined NM + PRT. Interventions were administered, and outcomes were assessed using the Numeric Pain

Rating Scale (NPRS), Neck Disability Index (NDI), and hand grip strength. Data were analyzed using one-way

ANOVA and Kruskal–Wallis test with significance set at p ≤ 0.05.

Results: All groups showed significant improvements in pain and disability. The combined NM + PRT group

demonstrated the greatest reduction in NPRS (6.93 ± 1.62) and improvement in NDI (13.87 ± 8.55), indicating

superior effectiveness. Grip strength improved in all groups; however, no statistically significant difference was

observed between them (p > 0.05).

Conclusion: Both NM and PRT are effective in managing cervical radiculopathy, but their combined application

provides superior outcomes in reducing pain and improving functional disability. This combined approach can

be considered a safe and effective non-invasive treatment option.

Patients typically present with radiating neck pain into the upper limb, accompanied by numbness, tingling, and

muscle weakness.

involvement.

with C5–C6 and C6–C7 being the most commonly affected levels.

Diagnosis involves a combination of clinical examination and imaging. The Wainner test cluster, including

Spurling’s test, cervical distraction, cervical rotation, and upper limb tension test, provides high diagnostic

accuracy.

MRI is commonly used for confirmation, although imaging findings may not always correlate with

muscle tension and pain by placing tissues in a position of comfort.

Although both techniques have shown beneficial effects, comparative evidence is limited. Therefore, this study

aims to compare the effectiveness of neural mobilization and positional release technique in individuals with

cervical radiculopathy.

Sample Size: 45 subjects

Source of Subjects: PSRI Hospital, Delhi

Method of Sampling: simple random

• Both males and females

• Unilateral or bilateral upper limb symptoms

• History of cervical spine surgery

• Use of steroidal anti-inflammatory drugs

• Presence of red flag conditions (tumor, fracture, osteoporosis, etc.)

• Lack of willingness to participate

• Numeric Pain Rating Scale (NPRS)

(mild tension, numbness, or tingling without discomfort), held for 10 seconds, and repeated for 10 repetitions.

Participants were treated using PRT in a supine position with the cervical spine in neutral. Trigger points were

identified and marked. The therapist positioned the patient into a position of maximum comfort (reducing pain

by approximately 80%) using gentle cervical movements. Each position was held for 90 seconds before

returning to neutral.

Participants received both PRT and neural mobilization. Initially, PRT was applied to release trigger points (held

for 90 seconds per point, repeated for multiple points). After a 5-minute rest period, neural mobilization

techniques were performed as described in Group 1.

A total of 45 patients with cervical radiculopathy were recruited from the physiotherapy OPD and equally

distributed into three groups (n = 15 each).

Group 1 (Neural Mobilization) showed a mean reduction in NPRS score of 5.87 ± 1.81. Group 2 (Positional

Release Technique) demonstrated a mean reduction of 3.87 ± 1.36. Group 3 (combined Neural Mobilization and

Positional Release Technique) showed the greatest improvement, with a mean reduction of 6.93 ± 1.62. Overall,

the combined intervention group exhibited superior pain reduction compared to the other groups.

improvement, with a mean change of 13.87 ± 8.55 (95% CI: 9.13–18.60), indicating better functional

recovery.

Fig. 2: Change in Neck Disabilty Index Scores (Pre – Post)

The change in grip strength across the three groups was analyzed using the Kruskal– Wallis test, which

showed no statistically significant difference (H = 2.115, df = 2, p = 0.347). This indicates that improvements

in grip strength were comparable across all groups.

Fig. 3: Change in Grip Strength (Pre – Post)

The present study compared Neural Mobilization (NM), Positional Release Technique (PRT), and their

combined application in cervical radiculopathy using pain, disability, and grip strength outcomes. All

interventions reduced pain; however, the combined NM + PRT group showed the greatest improvement,

indicating superior effectiveness. This may be due to the combined effect of improved neural mobility and

reduced muscle tension, addressing both neural and myofascial components of pain.

All groups also demonstrated improvement in neck disability, with the combined group showing the most

significant change. This may be attributed to reduced pain, improved cervical mobility, and decreased neural

irritation, supporting the benefit of a multimodal approach.

Grip strength improved in all groups, but no significant between-group difference was observed, likely

because the interventions focused on pain relief rather than strengthening.

Overall, while NM and PRT are effective individually, their combined application provides better outcomes

in pain reduction and functional improvement. These findings align with previous studies by Rafiq S., Zafar

H., and Sweety Charles Carvalho, further supporting the effectiveness of a combined treatment approach.