Effect of Manual Therapy in Reducing Neck Pain in Patients with Hernia Nucleus Polposus Cervicalis
DOI:
https://doi.org/10.26911/theijmed.2024.09.01.12Abstract
Background: Herniated Nucleus Pulposus Cervicalis (HNPC) is a medical condition characterized by the posterior or posterolateral protrusion of the intervertebral disc, resulting from the degeneration of the fibrous annulus. This protrusion exerts pressure on the nerve roots and spinal cord, leading to the development of neurological disorders. The objective of this study was to assess the efficacy of manual therapy in alleviating neck pain among patients diagnosed with cervical herniated nucleus pulposus.
Subjects and Method: A randomized controlled trial was carried out at JIH Hospital in Yogyakarta from August to September 2023. Fourteen patients diagnosed with cervical herniated nucleus pulposus (HNPC) were purposively sampled for the study. Seven patients underwent manual therapy as an intervention, while the remaining seven received standard treatment as the control group. The dependent variable assessed was neck pain, measured using a visual analogue scale (VAS). The independent variable was orthopedic manual physical therapy. The differences in neck pain scores between the two groups were analyzed using an independent t-test.
Results: Following the intervention, the pain score in the intervention group (Mean 2.43; SD= 1.13) exhibited a significant reduction compared to the control group (Mean= 4.86; SD= 0.90), with a p-value of 0.001.
Conclusion: Orthopedic manual therapy effectively alleviates neck pain in individuals with cervical herniated nucleus pulposus.
References
Binder AI (2007). Cervical spondylosis and neck pain. BMJ. 334(7592): 527–531. https://doi.org/10.1136%2Fbmj.39127.608299.80.
Bishop MD, Torres-Cueco R, Gay CW, Lluch-Girbés E, Beneciuk JM, Bialo-sky JE (2015). What effect can manual therapy have on a patient's pain experience?. Pain Manag. 5(6): 455–464. https://doi.org/10.2217%2-Fpmt.-15.39.
Bono CM, Ghiselli G, Gilbert TJ, Kreiner DS, Reitman C, Summers JT, Baisden JL, et al. (2010). North American spine society diagnosis and treatment of cervical radiculopathy from dege-nerative disorders. Spine J. 11(1):64-72. https://doi.org/10.1016/j.spinee.-2010.10.023.
Boyles R, Toy P, Mellon J, Hayes M, Ham-mer B (2011). Effectiveness of manual physical therapy in the treatment of cervical radiculopathy a systematic review. J Man Manip Ther. 19(3):135-42. https://doi.org/10.1179/2042618-61-1y.0000000011.
Chen S, Fu P, Wu H, Pei M (2017). Menis-cus, articular cartilage and nucleus pulposus: a comparative review of cartilage-like tissues in anatomy, development and function. Cell Tissue Res. 370(1): 53-70. https://doi.org/10.1007/s00441-017-2613-0.
Cicco FLD, Willhuber GOC (2023). Nucleus Pulposus Herniation. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. PMID: 31194447
Dydyk AM, Massa RN, Mesfin FB (2023). Disc Herniation. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://-www.ncbi.nlm.nih.gov/books/NBK441822/.
Hidalgo B (2016). Evidence based ortho-paedic manual therapy for patients with nonspecific low back pain: An integrative approach. J Back Muscu-loskelet Rehabil. 29(2): 231-239. https://doi.org/10.3233/bmr-150619.
Hing W, Hall T, Mulligan B (2019). The Mulligan concept of manual therapy - 2nd edition. https://doi.org/10.1080/-10669817.2017.1358249.
Hoy D, March L, Woolf A, Blyth F, Brooks P, Smith E, Vos T, et al. (2014). The global burden of neck pain: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 73(7): 1309-15. https://doi.org/10.1136/an-nrheumdis-2013-204431.
Joshi S, Balthillaya G, Neelapala YVR (2019). Thoracic Posture and Mobility in Mechanical Neck Pain Population: A Review of the Literature. Asian Spine J. 13(5): 849–860. https://doi.-org/-10.31616%2Fasj.2018.0302.
Kazeminasab S, Nejadghaderi A, Amiri P, Pourfathi H, Araj-Khodaei M, Sull-man MJM, Kolahi AA, Safiri S (2022). Sakit leher: epidemiologi global, tren dan faktor risiko. BMC Musculoskelet Disord. 23: 26. https://doi.org/10.1186/s12891-021-04957-4.
Kim DH, Kim CJ, Son SM (2018). Neck pain in adults with forward head posture: Effects of craniovertebral angle and cervical range of motion. Osong Public Health Res Perspect. 9(6): 309–313. https://doi.org/10.24-171%2Fj.phrp.-2018.9.6.04.
Latash ML (2018). The focus is on retrai-ning the coordination of movement patterns, not the range of movement or strength of muscle activation. J Neurophysiol. 120(1): 88–104. https:-//doi.org/10.1152%2Fjn.00084.2018.
Meleger AL, Krivickas LS (2007). Neck and back pain: musculoskeletal disorders. Neurol Clin. 25(2): 419-38. https://-doi.org/10.1016/j.ncl.2007.01.006.
Misailidou V, Malliou P, Beneka A, Karagi-annidis A, Godolias G (2010). Assess-ment of patients with neck pain: a review of definitions, selection crite-ria, and measurement tools. J Chiropr Med. 9(2): 49–59. https://doi.org/10-.1016%2Fj.jcm.2010.03.002.
Nadeak B (2019). Penegakan diagnosis dan penanggulangan Cervical Herniated Nucleus Polposus. Jurnal Pro-Life. 6(2): 191-202. https://doi.org/10.335-41/jpvol6Iss2pp102.
Nair SP, Panchabhai CS, Panhale V (2022). Chronic neck pain and respiratory dysfunction: a review paper. Bull Fac Phys Ther. 27: 21. https://-doi.org/10.1186/s43161-022-00078-8.
Qu N, Tian HC, Martino ED, Zhang B (2022). Neck pain: Do we know enough about the sensorimotor control system?. Front. Comput. Neurosci. 16: 946514. https://doi.-org/10.33-89/fncom.2022.946514.
Ridder DD, Adhia D, Vanneste S (2021). The anatomy of pain and suffering in the Neuroscience & Biobehavioral Re-views. 130: 125-146. https://doi.org/-10.1016/j.neubiorev.2021.08.013.
Vicenzino B, Paungmali A, Teys P (2007). Mulligan's mobilization with movement, positional faults and pain relief: current concepts from a critical review of literature. Man Ther. 12(2): 98-108. https://doi.org/10.1016/j.math.2006.07.012.
Westad K, Tjoestolvsen F, Hebron C (2019). The effectiveness of Mulligan's mobilisation with movement (MWM) on peripheral joints in musculoskeletal (MSK) conditions: A systematic review. Musculoskelet Sci Pract. 39: 157-163. https://doi.org/10.1016/j.m-sksp-.2018.12.001.
WHO (2022). Musculoskeletal health. Re-trieved from https://www.who.int-/news-room/fact-sheets/detail/mus-culoskeletal-conditions.
