G. Noel Squires
© 2015 Courtney Naimi
Background and Purpose: Management of cervical radiculopathy can include cervical traction, neural mobilization, manual therapy, and therapeutic exercise, whereas management of lateral epicondylitis can include eccentric tendinopathy management, manual therapy, and therapeutic exercise. Some evidence exists discussing neuromobilization for the management of axial diagnoses. However, there is sparse literature describing neuromobilization for management of both the presence of right C7, C8 radiculopathy and contralateral lateral epicondylitis. Therefore, the purpose of this case report is to discuss the outcomes of neuromobilization techniques for a patient presenting with right C7, C8 cervical radiculopathy with contralateral lateral epicondylitis. Case Description: A 64-year-old male satisfied the clinical prediction rule for right C7, C8 radiculopathy and contralateral epicondyle pain. Management of C7, C8 included manual therapy, stretching, strengthening exercises and neuromobilization techniques. Management of lateral epicondylitis on the left side included manual therapy, eccentric strengthening, and patient education. Outcomes: Improvements from baseline to discharge were noted. The QuickDash score improved from 15% to 6.8%. Visual Analog Scale gains were reported from 8/10 to 3/10 at the time of his discharge, and the Neck Disability Index revealed no change with 4% disability at both the initial examination and discharge. The patient’s examination showed C7, C8 myotomal weakness and dermatomal parasthesia. Lateral Epicondylitis improved with increased grip strength from 32.5kg to 35 kg and the patient’s symptoms declined, with improved function following six therapy sessions. Discussion: The results of this case report suggest that neuromobilization along with manual therapy, therapeutic exercise, and education, may be beneficial for the management of cervical radiculopathy and contralateral lateral epicondylitis. Nonetheless, ongoing studies are needed to further investigate the management of both of these diagnoses.
Naimi, Courtney, "The Effects Of Neuromobilization Combined With Posture Training In The Management Of A Patient With Cervical Radiculopathy: A Case Report" (2015). Case Report Papers. 55.