Pain, muscular tenderness, cervical and shoulder mobility in patients with cervical radiculopathy randomly treated with surgery, physiotherapy or a cervical collar

This prospective, randomised study compares the efficacy of surgery and conservative treatments in patients with cervical radiculopathy. The study group comprised 81 patients with long-lasting cervicaloradiculopathy, with a pain distribution corresponding to a significant nerve root compression, verified by magnetic resonance imaging or computed tomographic myelography. The patients were randomly allocated to surgery, physiotherapy or to wearing a cervical collar. The therapeutic effects were evaluated with respect to pain intensity on a visual analogue scale, pain distribution by pain drawing, and muscle tenderness by manual palpation. Shoulder and cervical range of motion was measured. The controls were performed before treatment, and 4 and 12 months after the start of the treatment. Before treatment, the groups were uniform. After treatment, the surgery and physiotherapy groups reported lower pain intensity and fewer painful areas compared to the collar group. The surgery group showed a reduced tenderness score compared to the two conservatively treated groups, and improved shoulder motion compared to the collar group. However, after 1 year, there were no significant differences between the treatment groups. The conclusion is therefore that one treatment is as good as any other of the three treatments studied although there is some difference in time when the improvement takes place.