Question:I am seeing a physical therapist for neck and arm pain. My symptoms are caused by a disc pressing on the nerve. My pain seem much better after only a week. Since they always do three or four different treatments on me, how can they tell which one is really working?
Answer:Combining several modalities (treatment methods) is not uncommon in the treatment of cervical radiculopathy (CR). CR is another term for the type of neck and arm pain you are having.
In general, there's been a shift in the focus of studies in health care. Researchers and scientists along with doctors and physical therapists are looking for solid support that the treatment prescribed for various patients is working. We call this evidence-based medicine.
Many musculoskeletal problems have a different underlying cause. This means studies must be done in each area to look for proof that the treatment used is working. In fact, we now try to find the best way to manage each type of injury, illness, or other conditions.
In the case of CR, it appears that a multimodal approach works best. Patients with CR who receive manual therapy and strengthening exercises along with neck traction seem to have the best early results.
This is important news because neck and arm pain can be very disabling. Finding a best practice treatment model that has short-term positive results may reduce or prevent disability in the long-run.
Right now, we still don't know if some of the modalities used work better than others. Research is ongoing to find out what combination of treatment tools works best. How often the patient should be treated, by what methods, and in what order are still being tested out.Joshua A. Cleland, PT, PhD, OCS, FAAOMPT, et al. Predictors of Short-Term Outcome in People with a Clinical Diagnosis of Cervical Radiculopathy. In Physical Therapy. December 2007. Vol. 87. No. 12. Pp. 1619-1632.
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