Effectiveness of Cervico-Thoracic Manual Therapy Combined with Deep Neck Flexor Training in Patients with Shoulder Pain Due to Cervical Radiculopathy(A RCT

Abstract

Objective: Neurological dysfunction brought on by constriction and irritation of the spinal nerves or nerve roots of the cervical spine is known as cervical radiculopathy. This study looked at how deep neck flexor (DNF) exercises combined with cervico-thoracic mobilization exercises improved shoulder discomfort and functional impairment.
Patients and methods: This randomized controlled trial was conducted at ANS Hospital between September 25, 2025, and December 24, 2025, with fifty participants who had persistent neck discomfort. They were divided into two groups at random. Group-A received cervico-thoracic mobilization (10 minutes) and deep neck flexor training (10 minutes), while Group-B, the control group, received conventional physical therapy (i.e., physical therapy agents, stretching, and isometric exercises) for the same amount of time as Gp-A. Every participant experienced a 20-day intervention. They were evaluated for functional impairment and shoulder pain intensity using a visual analog scale (VAS) and DASH before and after 20 days of therapy.
Results: Compared to baseline, both the groups showed a significant decrease in shoulder pain and disability (p <0.05), And there was a significant increase in Neck ROMs. The improvement of the mobilization with DNF training group was significantly Higher than the control group. Moreover, the improvement of the DNF group was significantly higher than the control group (p<0.05).
Conclusions: The cervico-thoracic mobilization exercises with DNF were better than traditional physiotherapy to treat shoulder pain and functional disability due to cervical radiculopathy.

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