Effects of Thoracic Screw Manipulation in Patients With Cervical Radiculopathy
Condition: Cervical Radiculopathy
MeSH terms: Radiculopathy
Study type: Interventional

Summary: 
      Cervical radiculopathy is a pain and/or sensorimotor deficit syndrome that is defined as
      being caused by compression of a cervical nerve root. The compression can occur as a result
      of disc herniation, Spondylosis, instability, trauma, or rarely, tumors.

      Thoracic spine manipulation (TSM) is defined as a high-velocity/low amplitude movement or
      "thrust" directed at any segment of the thoracic spine. Recent research has shown that
      Thoracic Joint Manipulation directed to the thoracic spine provides a therapeutic benefit to
      patients with neck pain and has been suggested as an appropriate strategy to minimize the
      risks associated with manipulation of the cervical spine
    

Detailed description: 
      Patient presentations can range from complaints of pain, numbness, and/or tingling in the
      upper extremity to electrical type pains or even weakness. Disc herniation accounts for
      20-25% of the cases of cervical radiculopathy. Most of the time cervical radiculopathy
      appears unilaterally; however it is possible for bilateral symptoms to be present if severe
      bony spurs are present at one level, impinging/irritating the nerve root on both sides. If
      peripheral radiation of pain, weakness, or pins and needle are present, the location of the
      pain will follow back to the concerned affected nerve root Manual techniques include
      positional release technique, muscle energy technique, myofascial release technique, Cyriax
      technique, Natural Apophyseal Glides and Sustained Natural Apophyseal Glides, manual pressure
      release, proprioceptive neuromuscular facilitation and ischemic compression.

      Thoracic spine manipulation (TSM) is defined as a high-velocity/low amplitude movement or
      "thrust" directed at any segment of the thoracic spine. Recent research has shown that
      Thoracic Joint Manipulation directed to the thoracic spine provides a therapeutic benefit to
      patients with neck pain and has been suggested as an appropriate strategy to minimize the
      risks associated with manipulation of the cervical spine
    

Intervention name(s): Thoracic Manipulation and Sustained Natural Apophyseal Glides and conventional therapy; Sustained Natural Apophyseal Glides and conventional therapy
Intervention type(s): Other; Other
Intervention description(s): After the segmental mobility examination of thoracic spine, the therapist will apply a high-velocity, end range screw thrust to a restricted segment of the thoracic spine as described by Maitland.; Position of therapist: stands beside the patient, while his\her head is cradled between your body and your right forearm (when you stand at his\her right side). Gentle pressure is now applied in a ventral direction on the spinous process of C7 while the skull remains still due to the control of your right forearm. (The really gentle moving force to do this comes from your left arm via the thenar eminence over the little finger on the spine of C7).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: pain; thoracic manipulation; sustained natural epiphyseal glides; neck disability index