Cervical Radiculopathy, Chronic Neck Pain
Conditions
Keywords
Cervical Epidural Injection, Cervical Radiculopathy, Chronic Neck Pain, Cervical Stabilization Exercises, Physical Therapy, Neck Disability
Brief summary
Chronic neck pain can negatively affect daily activities, work ability, and quality of life. Cervical epidural block is commonly used to reduce pain and inflammation, while exercise and physical therapy aim to improve muscle strength, endurance, movement control, and physical function. However, there is limited evidence comparing cervical epidural block alone with its combined use with exercise or physical therapy. This study aims to compare the effects of three treatment approaches in patients with chronic neck pain associated with cervical disc pathology or degenerative changes. Participants will receive cervical epidural block alone, cervical epidural block combined with cervical stabilization exercises, or cervical epidural block combined with physical therapy. Pain intensity, neck-related disability, and quality of life will be evaluated before treatment and at 1, 3, and 6 months after treatment using the Numeric Rating Scale, Neck Disability Index, and 12-Item Short Form Health Survey. The study will determine whether adding exercise or physical therapy to cervical epidural block provides additional clinical and functional benefits.
Detailed description
Chronic neck pain is a common musculoskeletal condition associated with limitations in daily activities, reduced work capacity, and impaired quality of life. Cervical disc degeneration and herniation are among the structural conditions that may contribute to persistent neck pain. Although education, medications, exercise, and physical therapy are commonly used as conservative treatments, symptoms may persist in some patients. Cervical epidural block is used in clinical practice to reduce pain and inflammation associated with cervical disc pathology. Exercise and physical therapy may complement the effects of cervical epidural block by improving cervical muscle strength, endurance, neuromuscular control, and physical function. However, evidence directly comparing cervical epidural block alone with its combined use with cervical stabilization exercises or physical therapy is limited. This three-group study will compare the clinical and functional effects of these treatment approaches in patients with chronic neck pain associated with cervical disc pathology or degenerative changes. The findings may help determine whether adding exercise or physical therapy to cervical epidural block provides additional benefits and may guide treatment planning for patients with chronic neck pain.
Interventions
PROCEDURECervical Epidural Steroid Injection
Participants receive a cervical epidural steroid injection for the treatment of chronic neck pain associated with cervical radiculopathy.
BEHAVIORALCervical Stabilization Exercise Program
Participants perform a cervical stabilization exercise program in addition to cervical epidural steroid injection.
OTHERPhysical Therapy Program
Participants receive a physical therapy program in addition to cervical epidural steroid injection.
Sponsors
Alİ Eman, MD
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Participants are assigned to one of three parallel treatment groups: cervical epidural block alone, cervical epidural block combined with cervical stabilization exercises, or cervical epidural block combined with physical therapy.
Eligibility
Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
* Aged 18 to 55 years * Neck pain lasting longer than 3 months * Diagnosis of cervical radiculopathy * Numeric Rating Scale (NRS) pain score of 5 or higher
Exclusion criteria
* History of spinal surgery * Cervical spondylolisthesis * Spinal stenosis * Presence of a neurological deficit * History of psychiatric disease * Polyneuropathy * History of spinal fracture * Pregnancy * History of malignancy * Known allergy to any medication used in the study * Central sensitization * Widespread pain * Regional pain associated with a systemic disease
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Pain Intensity Assessed by the Numeric Rating Scale | Baseline and 1, 3, and 6 months after treatment | Pain intensity will be assessed using the Numeric Rating Scale (NRS). Participants rate their pain on an 11-point scale ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Lower scores indicate lower pain intensity. Changes from baseline will be compared among the three treatment groups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Neck-Related Disability Assessed by the Neck Disability Index | Baseline and 1, 3, and 6 months after treatment | Neck-related disability will be assessed using the Neck Disability Index (NDI). The questionnaire consists of 10 items, each scored from 0 to 5, with a total score ranging from 0 to 50. Higher scores indicate greater neck-related disability. Changes from baseline will be compared among the three treatment groups. |
| Change in Health-Related Quality of Life Assessed by the 12-Item Short Form Health Survey | Baseline and 1, 3, and 6 months after treatment | Health-related quality of life will be assessed using the 12-Item Short Form Health Survey (SF-12). The questionnaire provides Physical Component Summary and Mental Component Summary scores. Higher scores indicate better health-related quality of life. Changes from baseline will be compared among the three treatment groups. |
Countries
Turkey (Türkiye)
Contacts
CONTACTYUNUS TÜRKYILMAZ, MD
PRINCIPAL_INVESTIGATORKEMAL NAS, MD, Professor
Sakarya University Training and Research Hospital, Department of Algology
STUDY_CHAIRRIDVAN IŞIK, MD
Sakarya University Training and Research Hospital, Department of Algology
Outcome results
None listed