Clinical practice guideline for Traditional Chinese Medicine: cervical radiculopathy

Cervical radiculopathy (CR) poses a significant challenge due to its debilitating impact on physical function, daily activities, psychological well-being, and social engagement. Traditional Chinese Medicine (TCM) has emerged as a valuable approach in managing CR. This study aims to present a comprehensive clinical practice guideline for the management of CR through TCM. Utilizing internationally recognized guideline standards, we meticulously developed this guideline. The Grading of Recommendations Assessment, Development, and Evaluation approach was employed to rigorously assess evidence quality and recommendation strength. Recommendations were formulated through the nominal group technique. Expert consensus identified nine clinical questions and twenty-three outcome indicators. After careful consideration of evidence quality, balance of benefits and harms, patient preferences, costs, clinical feasibility, accessibility, and clinical acceptability, the guideline working group formulated seventeen recommendations. These recommendations encompass various aspects such as diagnosis, TCM syndrome types, Chinese medicine compounds, Chinese patent medicines, acupuncture, manual therapy, traditional exercise therapy, surgical indications, and preventive measures. The majority of recommendations were weakly suggested or consensus-based, with the exception of acupuncture and manual therapy, which received strong recommendations. This guideline serves as a valuable resource for enhancing clinical decision-making and contributing to the comprehensive management of patients with CR.