By Dr. Jerome Fryer, Chiropractor
Cervical radiculopathy (CR) — often experienced as neck pain radiating into the arm, accompanied by numbness or weakness — can significantly impact daily life. Many patients wonder: What’s the most effective conservative treatment? A 2025 systematic review in the Journal of Pain Research analyzed eight clinical trials to compare manual therapy, traction, and conventional exercise for CR. Here’s what the evidence reveals, and how it informs my approach at Kelowna’s Fryer Chiropractic.
Key Findings from the Study
The meta-analysis evaluated 632 patients with CR, comparing three treatments:
- Manual Therapy (MT) Alone: Spinal adjustments, mobilizations, and soft tissue work.
- MT + Traction: Manual therapy combined with mechanical or manual cervical traction.
- Conventional Care (Exercise/Other Therapies): Non-manual approaches like strengthening exercises.
Results:
- Pain Relief (VAS Scores):
- MT alone had a 59.5% probability of being the most effective.
- MT + traction followed at 39.6%, while conventional care ranked lowest (0.9%).
- Functional Improvement (NDI Scores):
- MT alone again led with a 68.1% probability of optimal improvement.
- Traction added no significant benefit over MT alone (*difference: 0.13, 95% CI: -0.72, 0.98*).
Conclusion: Manual therapy outperformed other approaches for both pain and function. Traction, while commonly used, did not provide meaningful additional gains in most cases.
What This Means for Your Care
As a chiropractor, my goal is to deliver evidence-based care tailored to your needs. This study reinforces that:
1. Manual Therapy Should Be First-Line
- Adjustments and mobilizations reduce nerve irritation, improve joint mobility, and address muscle imbalances — all critical for CR recovery.
- In my practice, I prioritize techniques like:
- Manual decompression to help restore vertebral spacing to improve the facet gapping.
- Mobilizations for stiff or acute cases.
- Soft tissue therapy to relieve muscle tension.
2. Traction Isn’t Always Necessary, but it is very Useful
While prolonged traction may help severe cases (e.g., confirmed foraminal stenosis), the research shows it’s rarely a game-changer. What I have found is that intermittent traction often works best in this case, to encourage both the influx of disc fluid and the expulsion of inflammatory products, which works in many cases.
- Patients with persistent radicular symptoms unresponsive to MT alone.
- Specific anatomical compression visible on imaging.
3. Active Participation Matters
The study’s “conventional care” group (exercise alone) had poor outcomes — highlighting that passive treatments aren’t enough. In our therapeutic alliance, I combine hands-on therapy with:
- Targeted exercises to stabilize the cervical spine.
- Postural education to prevent recurrence.
- Lifestyle modifications (e.g., ergonomic adjustments).
When to Seek Help
Consider booking an assessment if you experience:
✅ Neck pain radiating to the arm/shoulder.
✅ Tingling/numbness in the hands or fingers.
✅ Weakness when gripping or lifting.
✅ Limited neck motion worsening over time.
Early intervention with manual therapy can prevent chronic issues and reduce reliance on medications or surgery.
Your Next Steps
- Consultation: Let’s evaluate your symptoms and imaging (if available) to create a personalized plan.
- Treatment: Focused manual therapy + active rehab for lasting results.
- Prevention: Strategies to maintain spinal health long-term.
📞 Contact me today to start your recovery journey.
Why Trust This Approach?
This blog reflects current evidence, not trends. As the study notes:
“Manual therapy alone should be prioritized for cervical radiculopathy unless specific criteria warrant traction.”
I’m committed to transparent, science-backed care — because your healing journey deserves nothing less.
References:
Xu X, Ling Y. (2025). Manual Therapy for Cervical Radiculopathy. Journal of Pain Research. [Full study available here].