Contralateral Neural Tissue Mobilization for Cervical Radiculopathy

ConditionsCervical Radiculopathy Pain Neuropathic Pain Radicular Pain

Trial statusNot yet recruiting

Trial phaseNot applicable

Trial typeInterventional

Biological sexAll

Age18+

SponsorEvidence In Motion

About this trial

Cervical radiculopathy (CR) is a common form of peripheral neuropathic pain characterized by neck and upper extremity symptoms in a dermatomal distribution. Neural tissue mobilization (NTM) is an intervention shown to provide benefit for neuropathic pain presentations; however, some patients are unable to tolerate direct treatment of the symptomatic limb due to allodynia, hyperalgesia, or fear of movement. Early evidence from lower-extremity research suggests that contralateral NTM may produce therapeutic effects similar to ipsilateral treatment, but this approach has not been investigated in individuals with upper-extremity symptoms.

This exploratory case series aims to examine the immediate effects of contralateral NTM in adults presenting to outpatient physical therapy with CR. Participants will undergo pre- and post-treatment assessments of pain intensity, disability, fear-avoidance beliefs, pain distribution, and neurodynamic mechanosensitivity. Findings will provide preliminary evidence regarding whether contralateral NTM may serve as a viable treatment option when direct symptomatic limb treatment is not tolerated.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Age 18 years or older Presence of unilateral upper-extremity pain in a dermatomal distribution consistent with cervical radiculopathy (with or without neck pain)

Able to read and understand English

Willing and able to provide written informed consent

New patient to the clinic or established patient who meets inclusion criteria and has not previously received neural tissue mobilization as part of treatment

Disqualifiers

Bilateral upper-extremity pain

Upper-extremity pain that is non-dermatomal in distribution

Presence of contraindications or precautions preventing use of the contralateral limb for neural tissue mobilization (e.g., injury, allodynia, recent surgery, postsurgical complications)

Not willing to participate in the study

Trial design

Design model

Single group

Treatments tested in this trial

Contralateral Neural Tissue Mobilization (NTM)
Behavioral
A standardized 8-10 minute contralateral NTM protocol will be performed and includes: 1. Supine passive neurodynamic mobilization (ULNT1a pattern) with: * Cervical side flexion toward the non-symptomatic side * Movement to the point of resistance * 1-2 seconds of gentle engagement followed by release * Repeated 15 times 2. Supine passive neurodynamic mobilization with: * Neutral cervical position * Repeated 15 times 3. Supine passive neurodynamic mobilization with: * Cervical side flexion away from the non-symptomatic side * Repeated 15 times 4. Sitting active neurodynamic exercises (contralateral UE) * 10 active "sliders" * 10 active "tensioners" * 10 additional active "sliders" The neurodynamic pattern follows the ULNT1a sequence: shoulder abduction to 90°, external rotation, forearm supination, wrist/finger extension with ulnar deviation, and progressive elbow extension. Single treatment session delivered in-person by a trained physical therapist.

Treatment groups

40 Participants

are divided into 1 treatment group

Group A: Contralateral Neural Tissue MobilizationExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

Numeric Pain Rating Scale (NPRS)

Change in patient-reported upper-extremity pain intensity measured using the 0-10 Numeric Pain Rating Scale, where 0 = no pain and 10 = worst imaginable pain. The NPRS is commonly used in musculoskeletal research to quantify pain severity.

Time frame