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Conservative Management of Cervical Radiculopathy: A Systematic Review.

The Clinical journal of pain
January 1, 1970
Joshua Plener et al. (10 authors)
Systematic ReviewJournal ArticleHuman Study
Study Details

Study Goal

The researchers aimed to assess the effectiveness and safety of conservative interventions, including Low-Level Laser Therapy, for pain, disability, and range of motion in adults with cervical radiculopathy.

Results Summary

The study found very-low certainty evidence supporting Low-Level Laser Therapy for pain and disability in the immediate to short-term, and for improvements in cervical range of motion in the immediate term. The evidence was inconclusive for multimodal interventions.

Population

Adults with cervical radiculopathy (CR) diagnosed through clinical examination and/or diagnostic tests.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (10)
InterventionDirectionEndpointPopulationDosageImpactClaim #
acupuncture
decrease
pain and disability
adults with cervical radiculopathy
-
supporting the use of
#1
prednisolone
decrease
pain and disability
adults with cervical radiculopathy
-
supporting the use of
#2
cervical manipulation
decrease
pain and disability
adults with cervical radiculopathy
-
supporting the use of
#3
low-level laser therapy
decrease
pain and disability
adults with cervical radiculopathy
-
supporting the use of
#4
thoracic manipulation
increase
cervical range of motion
adults with cervical radiculopathy
-
supporting the use of
#5
low-level laser therapy
increase
cervical range of motion
adults with cervical radiculopathy
-
supporting the use of
#6
multimodal interventions
no change
pain
adults with cervical radiculopathy
-
inconclusive evidence for
#7
multimodal interventions
no change
disability
adults with cervical radiculopathy
-
inconclusive evidence for
#8
multimodal interventions
no change
range of motion
adults with cervical radiculopathy
-
inconclusive evidence for
#9
conservative management
no change
pain reduction
adults with cervical radiculopathy
-
inconclusive evidence for
#10
Abstract

OBJECTIVE: The purpose of this systematic review was to assess the effectiveness and safety of conservative interventions compared with other interventions, placebo/sham interventions, or no intervention on disability, pain, function, quality of life, and psychological impact in adults with cervical radiculopathy (CR). METHODS: We searched MEDLINE, CENTRAL, CINAHL, Embase, and PsycINFO from inception to June 15, 2022 to identify studies that were randomized controlled trials, had at least one conservative treatment arm, and diagnosed participants with CR through confirmatory clinical examination and/or diagnostic tests. Studies were appraised using the Cochrane Risk of Bias 2 tool and the quality of the evidence was rated using the Grades of Recommendations, Assessment, Development, and Evaluation approach. RESULTS: Of the 2561 records identified, 59 trials met our inclusion criteria (n = 4108 participants). Due to clinical and statistical heterogeneity, the findings were synthesized narratively. There is very-low certainty evidence supporting the use of acupuncture, prednisolone, cervical manipulation, and low-level laser therapy for pain and disability in the immediate to short-term, and thoracic manipulation and low-level laser therapy for improvements in cervical range of motion in the immediate term. There is low to very-low certainty evidence for multimodal interventions, providing inconclusive evidence for pain, disability, and range of motion. There is inconclusive evidence for pain reduction after conservative management compared with surgery, rated as very-low certainty. DISCUSSION: There is a lack of high-quality evidence, limiting our ability to make any meaningful conclusions. As the number of people with CR is expected to increase, there is an urgent need for future research to help address these gaps.

Medical Subject Headings (MeSH)
AdultHumansConservative TreatmentRadiculopathyQuality of LifeAcupuncture TherapyPainRandomized Controlled Trials as Topic
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality75/10
Citation Metrics
Total Citations8
Citations/Year4.0
Relative Citation Ratio3.80
NIH Percentile89.4%
Research Impact Scores
APT Score0.75
Weight Score1.57
Normalized Score0.61
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