The effectiveness of conservative treatment for patients with cervical radiculopathy: a systematic review

Erik J Thoomes, Wendy Scholten-Peeters, Bart Koes, Deborah Falla, Arianne P Verhagen

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

OBJECTIVES: The aim of this systematic review is to assess the effectiveness of conservative treatments for patients with cervical radiculopathy, a term used to describe neck pain associated with pain radiating into the arm. Little is known about the effectiveness of conservative treatment for patients with cervical radiculopathy.

METHODS: We electronically searched the Cochrane Controlled Trials Register, MEDLINE, EMBASE, and CINAHL for randomized clinical trials. Conservative therapies consisted of physiotherapy, collar, traction etc. Two authors independently assessed the risk of bias using the criteria recommended by the Cochrane Back Review Group and extracted the data. If studies were clinically homogenous, a meta-analysis was performed. The overall quality of the body of evidence was evaluated using the GRADE method.

RESULTS: Fifteen articles were included that corresponded to 11 studies. Two studies scored low risk of bias. There is low-level evidence that a collar is no more effective than physiotherapy at short-term follow-up and very low-level evidence that a collar is no more effective than traction. There is low-level evidence that traction is no more effective than placebo traction and very low level-evidence that intermittent traction is no more effective than continuous traction.

DISCUSSION: On the basis of low-level to very low-level evidence, no 1 intervention seems to be superior or consistently more effective than other interventions. Regardless of the intervention assignment, patients seem to improve over time, indicating a favorable natural course. Use of a collar and physiotherapy show promising results at short-term follow-up.

Original languageEnglish
Pages (from-to)1073-86
Number of pages14
JournalThe Clinical Journal of Pain
Volume29
Issue number12
DOIs
Publication statusPublished - Dec 2013
Externally publishedYes

Fingerprint

Radiculopathy
Traction
Neck Pain
MEDLINE
Meta-Analysis
Conservative Treatment
Randomized Controlled Trials
Placebos
Pain

Keywords

  • Humans
  • Neck Pain
  • Physical Therapy Modalities
  • Radiculopathy
  • Treatment Outcome
  • Journal Article
  • Review

Cite this

Thoomes, Erik J ; Scholten-Peeters, Wendy ; Koes, Bart ; Falla, Deborah ; Verhagen, Arianne P. / The effectiveness of conservative treatment for patients with cervical radiculopathy : a systematic review. In: The Clinical Journal of Pain. 2013 ; Vol. 29, No. 12. pp. 1073-86.
@article{782644b784474040a3f32641f94d7d98,
title = "The effectiveness of conservative treatment for patients with cervical radiculopathy: a systematic review",
abstract = "OBJECTIVES: The aim of this systematic review is to assess the effectiveness of conservative treatments for patients with cervical radiculopathy, a term used to describe neck pain associated with pain radiating into the arm. Little is known about the effectiveness of conservative treatment for patients with cervical radiculopathy.METHODS: We electronically searched the Cochrane Controlled Trials Register, MEDLINE, EMBASE, and CINAHL for randomized clinical trials. Conservative therapies consisted of physiotherapy, collar, traction etc. Two authors independently assessed the risk of bias using the criteria recommended by the Cochrane Back Review Group and extracted the data. If studies were clinically homogenous, a meta-analysis was performed. The overall quality of the body of evidence was evaluated using the GRADE method.RESULTS: Fifteen articles were included that corresponded to 11 studies. Two studies scored low risk of bias. There is low-level evidence that a collar is no more effective than physiotherapy at short-term follow-up and very low-level evidence that a collar is no more effective than traction. There is low-level evidence that traction is no more effective than placebo traction and very low level-evidence that intermittent traction is no more effective than continuous traction.DISCUSSION: On the basis of low-level to very low-level evidence, no 1 intervention seems to be superior or consistently more effective than other interventions. Regardless of the intervention assignment, patients seem to improve over time, indicating a favorable natural course. Use of a collar and physiotherapy show promising results at short-term follow-up.",
keywords = "Humans, Neck Pain, Physical Therapy Modalities, Radiculopathy, Treatment Outcome, Journal Article, Review",
author = "Thoomes, {Erik J} and Wendy Scholten-Peeters and Bart Koes and Deborah Falla and Verhagen, {Arianne P}",
year = "2013",
month = "12",
doi = "10.1097/AJP.0b013e31828441fb",
language = "English",
volume = "29",
pages = "1073--86",
journal = "The Clinical Journal of Pain",
issn = "0749-8047",
publisher = "Lippincott Williams and Wilkins",
number = "12",

}

The effectiveness of conservative treatment for patients with cervical radiculopathy : a systematic review. / Thoomes, Erik J; Scholten-Peeters, Wendy; Koes, Bart; Falla, Deborah; Verhagen, Arianne P.

In: The Clinical Journal of Pain, Vol. 29, No. 12, 12.2013, p. 1073-86.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - The effectiveness of conservative treatment for patients with cervical radiculopathy

T2 - a systematic review

AU - Thoomes, Erik J

AU - Scholten-Peeters, Wendy

AU - Koes, Bart

AU - Falla, Deborah

AU - Verhagen, Arianne P

PY - 2013/12

Y1 - 2013/12

N2 - OBJECTIVES: The aim of this systematic review is to assess the effectiveness of conservative treatments for patients with cervical radiculopathy, a term used to describe neck pain associated with pain radiating into the arm. Little is known about the effectiveness of conservative treatment for patients with cervical radiculopathy.METHODS: We electronically searched the Cochrane Controlled Trials Register, MEDLINE, EMBASE, and CINAHL for randomized clinical trials. Conservative therapies consisted of physiotherapy, collar, traction etc. Two authors independently assessed the risk of bias using the criteria recommended by the Cochrane Back Review Group and extracted the data. If studies were clinically homogenous, a meta-analysis was performed. The overall quality of the body of evidence was evaluated using the GRADE method.RESULTS: Fifteen articles were included that corresponded to 11 studies. Two studies scored low risk of bias. There is low-level evidence that a collar is no more effective than physiotherapy at short-term follow-up and very low-level evidence that a collar is no more effective than traction. There is low-level evidence that traction is no more effective than placebo traction and very low level-evidence that intermittent traction is no more effective than continuous traction.DISCUSSION: On the basis of low-level to very low-level evidence, no 1 intervention seems to be superior or consistently more effective than other interventions. Regardless of the intervention assignment, patients seem to improve over time, indicating a favorable natural course. Use of a collar and physiotherapy show promising results at short-term follow-up.

AB - OBJECTIVES: The aim of this systematic review is to assess the effectiveness of conservative treatments for patients with cervical radiculopathy, a term used to describe neck pain associated with pain radiating into the arm. Little is known about the effectiveness of conservative treatment for patients with cervical radiculopathy.METHODS: We electronically searched the Cochrane Controlled Trials Register, MEDLINE, EMBASE, and CINAHL for randomized clinical trials. Conservative therapies consisted of physiotherapy, collar, traction etc. Two authors independently assessed the risk of bias using the criteria recommended by the Cochrane Back Review Group and extracted the data. If studies were clinically homogenous, a meta-analysis was performed. The overall quality of the body of evidence was evaluated using the GRADE method.RESULTS: Fifteen articles were included that corresponded to 11 studies. Two studies scored low risk of bias. There is low-level evidence that a collar is no more effective than physiotherapy at short-term follow-up and very low-level evidence that a collar is no more effective than traction. There is low-level evidence that traction is no more effective than placebo traction and very low level-evidence that intermittent traction is no more effective than continuous traction.DISCUSSION: On the basis of low-level to very low-level evidence, no 1 intervention seems to be superior or consistently more effective than other interventions. Regardless of the intervention assignment, patients seem to improve over time, indicating a favorable natural course. Use of a collar and physiotherapy show promising results at short-term follow-up.

KW - Humans

KW - Neck Pain

KW - Physical Therapy Modalities

KW - Radiculopathy

KW - Treatment Outcome

KW - Journal Article

KW - Review

U2 - 10.1097/AJP.0b013e31828441fb

DO - 10.1097/AJP.0b013e31828441fb

M3 - Article

VL - 29

SP - 1073

EP - 1086

JO - The Clinical Journal of Pain

JF - The Clinical Journal of Pain

SN - 0749-8047

IS - 12

ER -