Increase in Strength After Multimodal Pain Management Concept in Patients with Cervical Radiculopathy-A Non-Randomized, Uncontrolled Clinical Trial.

Abstract

Background and Objective: Although multimodal pain therapy (MPT) is widely used in pain management for chronic cervical radiculopathy, its effect on increasing muscle strength in patients with cervical radiculopathy is not well documented. This study aimed to evaluate the impact of a structured multimodal pain management program on muscle strength in these patients, using objective strength measurements as indicators of therapeutic success. Materials and Methods: This non-randomized, uncontrolled, prospective clinical study initially included 35 patients, but 10 were excluded due to incomplete data, resulting in a final sample of 25 patients (14 women and 11 men, aged 42 to 84 years) with cervical radiculopathy who underwent a multimodal pain management program at a specialized orthopedic clinic. Muscle strength was measured at admission and discharge using a hand-held dynamometer. Pain levels were assessed with the Numeric Rating Scale. An uncontrolled study design was chosen for ethical reasons, as it was deemed inappropriate to form a control group that would be deprived of necessary anti-inflammatory or analgesic medications. Result: Significant improvements were observed in overall muscle strength, with an 11% increase from 114.78 kg to 127.41 kg (p = 0.003). The strongest increase in strength was observed in the proximal cervical muscle groups, with a notable 22.9% (p < 0.001)improvement in the muscles involved in cervical inclination. However, no significant strength gains were detected in the peripheral muscle groups of the upper arm. Pain scores on the NRS decreased by 54.2% (p < 0.001). Conclusions: This study demonstrates that a multimodal pain management approach leads to significant improvements in muscle strength and pain reduction in patients with cervical radiculopathy. The increase in cervical muscle strength is closely associated with pain relief and improved functional outcomes, highlighting the value of conservative pain management strategies for these patients.