Addition of McKenzie Exercises to a Multimodal Physical Therapy Approach for Cervical Radiculopathy: A Case Report

Abstract

Cervical radiculopathy is a common subset of neck pain involving cervical nerve root irritation potentially resulting in numbness, radicular pain, and/or upper extremity weakness. The Neck Pain Clinical Practice Guidelines published by the American Physical Therapy Association does not support McKenzie exercises in isolation when treating cervical radiculopathy, but endorses a multimodal physical therapy approach for the management of cervical radiculopathy. The purpose of this case report is to exemplify the treatment of a patient with cervical radiculopathy utilizing McKenzie centralization exercises within a multimodal physical therapy approach for improved patient outcomes. The patient was a 49-year-old female with a past medical history of type 1 diabetes mellitus with a history of subacute cervical pain with left upper extremity radicular symptoms for four months consistent with cervical radiculopathy. Interventions included a multimodal physical therapy approach consisting of McKenzie cervical retraction exercises, thoracic manipulation, rib mobilizations, manual cervical traction, peripheral nerve mobilization, and scapular retraction with postural exercises. The patient received four visits over a five-week period with an emphasis on patient education and independence. Although McKenzie centralization exercises are not supported by the Neck Pain Clinical Practice Guideline (CPG) in isolation, adding these exercises to the supported recommendation of a multimodal physical therapy approach for cervical radiculopathy has promise.

Keywords: cervical radiculopathy; exercise; mckenzie; neck pain; physical therapy.