Cervical Radiculopathy On A Male Patient: A Retrospective Case Study

Alex Ochoa, SPT

Western University of Heath Sciences; Pomona, CA
Select Physical Therapy, Riverside, CA

Introduction/Background
Cervical radiculopathy refers to a change in neurological function that
results when a nerve root in the cervical spine (neck) becomes
inflamed or damaged.
Patient (JC) is a 55-year-old male electrician. Main job duty was installing
electrical wiring and ceiling fans for Fleetwood Homes. Was working full
time full duty prior to injury, transitioned to part time part duty.
He reported gradual onset of pain at his left shoulder and left cervical spine
due to repetitive heavy lifting and prolonged over head positioning.
Trouble sleeping, could not lay on left side, numbness and tingling at palm
and first three digits.
Physical Therapy intervention 1
Cervical mobilization: Unilateral upglides
Manual Therapy as a Management of Cervical Radiculopathy: A
Systematic Review. Sergio Borrella-Andrés et al.
According to this article manual therapy techniques with the best results
included those that focused on opening the intervertebral foramen area.
Furthermore, the application of manual therapy, regardless of the protocol
applied and the manual therapy selected has some benefits in reducing
chronic cervical pain and decreasing the index of cervical disability in
cervical radiculopathy in the short term.
Physical Therapy Intervention 2
Median nerve mobilization: Manual neural tension and neuro
dynamic mobilization
Effectiveness of manual physical therapy in the treatment of cervical
radiculopathy: a systematic review. R. Boyles et al.
Although a definitive treatment progression for treating CR has not been
developed a consensus exists within the literature that using manual
therapy techniques in conjunction with therapeutic exercise is effective
regarding increasing function, as well as AROM, while decreasing levels
of pain and disability.
Future Incorporated Plan of Care
High-velocity thrust to Tl T3 region sitting and High velocity thrust to
T3-T5 region supine
Treatment of a Patient with Cervical Radiculopathy Using Thoracic
Spine Thrust Manipulation, Soft Tissue Mobilization, and Exercise.
Michael Costello, MSPT, MTC
In this case report, manipulation techniques directed to the thoracic spine,
exercise, and soft tissue mobilization techniques directed to the upper
quarter were associated with a dramatic improvement in physical
impairments, pain, and function for a patient with cervical radiculopathy.

Lower cervical upglide/flexion rotary thrust manipulation.

Evidence-Based Approach to the Physical Therapy Diagnosis and

Management of Neck and Upper Extremity Pain using Cervical and
Thoracic Spine Thrust Manipulation: A Case Report

Thrust manipulations to the cervical and thoracic spine combined with an

AROM home exercise program as suggested for patients in the mobility
category of this treatment-based classification system were administered
with excellent outcomes in cervical ROM, pain, and disability for the
patient in this case report.

Key Findings
• Imagining confirmed left shoulder bicipital tendinitis and cervical
radiculopathy.
• MRI confirmed disc herniation at C6/C7.
• Upper Limb Tension Test: positive
• Spurling’s Test: positive
• Limited Cervical Rotation: L: 45 degrees; R: 55 degrees
• Palpation to left bicep tendon at supraglenoid tubercle aggravated
symptoms
References
• L Biceps MMT: 3+/5 Borrella-Andrés, S., Marqués-García, I., Lucha-López, M. O., Fanlo-
• Pec major/minor length test were positive. Mazas, P., Hernández-Secorún, M., Pérez-Bellmunt, A., Tricás-Moreno, J.
• Very rounded shoulders and scapular abduction in posture analysis M., & Hidalgo-García, C. (2021). Manual Therapy as a Management of
Cervical Radiculopathy: A Systematic Review. BioMed Research
International, 1–15. https://doi-
org.proxy.westernu.edu/10.1155/2021/9936981

Boyles, R., Toy, P., Mellon, J., Hayes, M., & Hammer, B. (2011).
Effectiveness of manual physical therapy in the treatment of cervical
radiculopathy: a systematic review. Journal of Manual & Manipulative
Therapy (Taylor & Francis Ltd), 19(3), 135–142. https://doi-

Team Collaboration Student Reflection org.proxy.westernu.edu/10.1179/2042618611Y.0000000011

Throughout my time in clinic, I learned about the
I observed the importance of documentation importance of evidence-based practice. When working Treatment of a Patient with Cervical Radiculopathy Using Thoracic Spine
between the physical therapists and the insurance with patients you want to give them the best Thrust Manipulation, Soft Tissue Mobilization, and Exercise. (2008).
providers. More specifically, workers’ compensation opportunity available to achieve their goals and a major Journal of Manual & Manipulative Therapy, 16(3), 129–135.
insurance. This particular patient needed more visits factor that plays into that is using treatment that has the
than what he was approved for initially in order to best evidence available. Furthermore, I learned about
maximize his rehabilitation. The importance of Paul E. Glynn & Joshua A. Cleland (2006) Evidence-Based Approach to
the importance of interpersonal communication with the Physical Therapy Diagnosis and Management of Neck and Upper
properly documenting came to light with scenarios your patient and being able to listen to them in order to
like these. I also got to witness the different Extremity Pain using Cervical and Thoracic Spine Thrust Manipulation: A
incorporate a patient centered approach. Also, I really Case Report, Journal of Manual & Manipulative Therapy, 14:3, 30E-45E,
approaches that multiple therapists take when appreciated the collaboration between the clinicians
working with the same patient. I believe this is a DOI: 10.1179/jmt.2006.14.3.30E
including the PTAs and AIDEs. It really does take a
positive aspect in order for the patient to receive team in order to provide the best care possible. Another
multiple types of treatments from different point of important lesson from clinical was just the everyday ins
Acknowledgments/Contacts
views. and outs of the clinic including insurance, scheduling, Alex Ochoa, SPT Jose.Ochoa@westernu.edu
and the importance of proper documentation. Karen Olson, PT Clinical Instructor KOOlson@selectmedical.com

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