Neck and arm pain arising from a cervical disc herniation is referred to as discogenic cervical radiculopathy (DCR) in the spine care literature.
DCR is relatively common in today’s patient populations and it is typically associated with patient limitations in their activities of daily living and persistent disability.1 The sixth and the seventh cervical nerve roots are the most frequently involved. Despite the high annual incidence of this condition,2 the identification of appropriate conservative management strategies appears to remain a clinical enigma for many patients.3-5
Causes of Altered Lordotic Curve and Disc Herniation
Abnormal alignment of the cervical lordotic curve from the side view (straightening and kyphosis) has been found to result in degenerative changes in the muscles, ligaments, intervertebral discs and bony structures of the cervical spine. These degenerative changes, in turn generates increased force on the spinal cord and neural elements leading to arm pain and altered nerve conduction / action potentials times and amplitudes.6-9 Recently, there has been a growing interest in the understanding of and rehabilitation of the cervical lordotic curvature as a clinical outcome or goal of patient care.10-13 Problematically, however, the available literature on conservative treatments for DCR patients has not addressed proper rehabilitation of the cervical lordotic alignment in specific patient populations.14,15 The development of effective intervention strategies and trials testing this concept in DCR patients is thus sorely needed.
Figure 1. Cervical Denneroll Device. Image ©Copyright CBP Seminars and Deed Harrison, LLC. Reprinted with Permission. All rights reserved.
New Breakthrough Randomized Trial
Recently a breakthrough randomized trial was conducted at Cairo University in Egypt and co-authored by CBP NonProfit President Dr. Deed Harrison, DC. The Cairo University team was led by Professor Ibrahim Moustafa, PT, PhD and included collaborating authors Professor Aliaa Diab PT, PhD and Shimaa Taha PT, MSc.16
Clinical features: The study investigated 40 patients with chronic pain and disability due to DCR. The short (10-weeks) and long term (1-year) outcomes of neck disability, neck pain, arm pain, and measures of neuro-physiology were assessed in this project.
Interventions: The investigation used a standard intervention frequency and duration of 3x per week for 10 weeks or 30 total treatment sessions. Patient participants were assigned equally to one of two groups: Denneroll group and Non-Denneroll Group. Of interest both groups received a standardized multiple treatment procedure protocol including:
- Spinal manipulative therapy for the thoracic spine,
- Myofascial stretching and release techniques to the cervical spine and anterior brachial plexus area,
- Tens and hotpacks to the cervical and upper thoracic regions,
- Functional and strengthening exercise protocol designed to improve strength, flexibility, posture, and reduce pain,
- A series of home care instructions.
Only the Denneroll group received the cervical denneroll in addition to the standardized multiple treatment techniques. Figure 1. shows the Cervical Denneroll device.
All treatments were applied 3x per week for 10 weeks. At the end of the 30 treatments, following a minimum of 1-day with no treatment, all subjects were re-evaluated. Lastly, treatment was then stopped and all subjects were followed for an additional 1-year to see if the 10-week outcomes were maintained at this long term follow up.
Important Findings and Conclusion
The addition of the cervical denneroll orthotic device to a multi-modal physical therapy intervention program was found to improve the cervical lordotic curvature by an average of 13° and improve anterior head translation by 12mm. This improvement in cervical curvature and posture in the Denneroll group was found to be associated with improvement in chronic neck pain, arm pain, and neck disability and a reduction in medication usage over the 1 year time period. Furthermore, in the group receiving the denneroll and curve correction, their peripheral nervous system speed was found to increase by 24% and the spinal cord–central conduction time–was found to increase by 23%!16
Figure 2. shows an example of a patient’s lateral cervical spine x-ray with a cervical kyphosis and then the 10-week and the long term follow up x-rays indicating correction.
Figure 2. Example Before, After 10 weeks of treatment, and 1 year follow up x-rays of a patient with a cervical kyphosis whose curve has been corrected towards a cervical lordosis with the Cervical Denneroll and other interventions. Image ©Copyright CBP Seminars and Deed Harrison, LLC. Reprinted with Permission. All rights reserved.
How Can You Get Help for Your Altered Posture and Spinal Arthritis and Disc Disease and Health Disorders?
Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their cervical spines back to health, and eliminate a potential source of progressive SADD, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See www.CBPpatient.com for providers in your area.