Clinical benefits of manual therapies for cervical spondylosis

Cervical spondylosis (CS) is a chronic degenerative condition that causes neck pain, stiffness, and numbness, which may radiate to the shoulder, arm, and hand. Conservative approaches such as manual therapy may relieve pain and improve mobility in patients with nerve compression. This case report aims to demonstrate that the symptoms of CS can be managed using selected manual therapy techniques.

A 45-year-old male with symptomatic Grade 2 spondylotic changes at the C5/C6 and C6/C7 levels, presenting with painful neck movements, restricted range of motion, and left-hand paresthesia, was treated systematically with selected manual therapy techniques. The interventions included myofascial release, cervical sustained natural apophyseal glides, cervical high-velocity, low-amplitude (HVLA) thrust manipulation, and manual cervical traction. Treatment outcomes were assessed using the Neck Disability Index (NDI), a derived Neck Flexibility Index (NFI), and a Numeric Rating Scale (NRS) for paresthesia.

Gradual relief of neck pain, stiffness, and hand paresthesia was observed within one month. The patient continued the prescribed neck exercises for three years to maintain the therapeutic effect, and no further episodes of aggravated neck pain or paresthesia were reported. A follow-up MRI scan performed after three years revealed significant remission of nerve root compression.

This case report suggests that selected manual therapy interventions may help reduce neck pain, improve range of motion, and relieve hand paresthesia due to CS.