Use of a multimodal conservative management protocol for the treatment of a patient with cervical radiculopathy.

OBJECTIVE

The purpose of this study is to describe and discuss the treatment of a cervical disk herniation using a sequential multimodal conservative management approach.

CLINICAL FEATURES: A 40-year-old man had complaints of headache and severe sharp neck pain radiating to his left shoulder down to his arm, forearm, and hand. Results of electromyography/nerve conduction studies were abnormal. Magnetic resonance imaging revealed a large disk protrusion at C5-C6 with indentation of the thecal sac and a spur at the posterior margin. Moderate left neural foraminal narrowing was present at C5-C6 with narrowed intervertebral disk space at C5-C6 and C6-C7.

INTERVENTION AND OUTCOME: High-velocity, low-amplitude chiropractic manipulation; electrotherapy; ice; and exercise were used for treatment. The Neck Disability Index was used as a primary and electromyography/nerve conduction studies as a secondary outcome measurement. Based on the Neck Disability Index, there was an overall 89.65% symptoms improvement from the baseline.

CONCLUSIONS

This case study demonstrated possible beneficial effects of the multimodal treatment approach in a patient with cervical radiculopathy.