Manual Therapy as a Management of Cervical Radiculopathy: A Systematic Review.

Cervical radiculopathy involves irritation or dysfunction of a nerve root in the neck, causing radiating pain and sometimes weakness or numbness. Because there is no agreed definition of the condition and prior research on manual therapy for it has been mixed, this systematic review pooled 17 randomised clinical trials published over the past 10 years to look at whether manual therapy improves pain, function, and range of motion. Across these trials, manual therapy was reported as effective for symptoms related to cervical radiculopathy, regardless of which technique or dose was used, though effects were generally described in the short term. The review could not determine which specific technique works best for cases confirmed by nerve conduction testing, and the authors noted that inconsistent definitions of radiculopathy and non-standardised manual therapy techniques across studies limit how confidently these findings can be interpreted.

Cervical radiculopathy is a condition where a nerve root in the neck becomes irritated or compressed, causing pain that radiates down the arm, along with possible numbness or weakness. Researchers wanted to know whether manual therapy, hands-on techniques like joint mobilisation or manipulation, could help with pain, movement, and daily function in people with this condition.

To find out, they reviewed 17 randomised clinical trials published in the last decade. Across these studies, manual therapy was linked to improvement in neck pain and disability in the short term, no matter which specific technique or amount of treatment was used. However, the researchers could not say which technique works best for people whose radiculopathy was confirmed with nerve testing, since most studies did not use this confirmation.

They also pointed out that there is no standard definition of cervical radiculopathy or agreed way of describing manual therapy techniques, which makes it hard to compare studies directly or be fully confident in the results.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This systematic review synthesised 17 randomised controlled trials from the past decade examining manual therapy for cervical radiculopathy, using PEDro and RoB 2.0 to appraise methodological quality. Outcomes assessed included pain, functional capacity (cervical disability), and range of motion, with searches conducted across PubMed, Web of Science, Scopus, PEDro, and Cochrane Library Plus following PRISMA guidance. Across the included trials, manual therapy was associated with improvement in radiculopathy-related symptoms in the short term regardless of technique type or dosage, but the review could not identify which specific manual therapy approach is most effective for cases with electrophysiologically confirmed nerve conduction abnormalities, since most trials lacked this diagnostic confirmation.

The authors explicitly flag the absence of a consensus definition and diagnostic criteria for cervical radiculopathy, along with inconsistent standardisation of manual therapy protocols across studies, as key limitations that constrain pooled interpretation and comparability between trials. Given these definitional and methodological inconsistencies, the review's conclusions should be read as indicating a consistent short-term signal across heterogeneous studies rather than robust, high-certainty evidence for any particular technique or protocol.