Overview
Chronic neck pain can negatively affect daily activities, work ability, and quality of life. Cervical epidural block is commonly used to reduce pain and inflammation, while exercise and physical therapy aim to improve muscle strength, endurance, movement control, and physical function. However, there is limited evidence comparing cervical epidural block alone with its combined use with exercise or physical therapy.
This study aims to compare the effects of three treatment approaches in patients with chronic neck pain associated with cervical disc pathology or degenerative changes. Participants will receive cervical epidural block alone, cervical epidural block combined with cervical stabilization exercises, or cervical epidural block combined with physical therapy. Pain intensity, neck-related disability, and quality of life will be evaluated before treatment and at 1, 3, and 6 months after treatment using the Numeric Rating Scale, Neck Disability Index, and 12-Item Short Form Health Survey. The study will determine whether adding exercise or physical therapy to cervical epidural block provides additional clinical and functional benefits.
Description
Chronic neck pain is a common musculoskeletal condition associated with limitations in daily activities, reduced work capacity, and impaired quality of life. Cervical disc degeneration and herniation are among the structural conditions that may contribute to persistent neck pain. Although education, medications, exercise, and physical therapy are commonly used as conservative treatments, symptoms may persist in some patients. Cervical epidural block is used in clinical practice to reduce pain and inflammation associated with cervical disc pathology.
Exercise and physical therapy may complement the effects of cervical epidural block by improving cervical muscle strength, endurance, neuromuscular control, and physical function. However, evidence directly comparing cervical epidural block alone with its combined use with cervical stabilization exercises or physical therapy is limited. This three-group study will compare the clinical and functional effects of these treatment approaches in patients with chronic neck pain associated with cervical disc pathology or degenerative changes. The findings may help determine whether adding exercise or physical therapy to cervical epidural block provides additional benefits and may guide treatment planning for patients with chronic neck pain.
Eligibility
Inclusion Criteria:
- Aged 18 to 55 years
- Neck pain lasting longer than 3 months
- Diagnosis of cervical radiculopathy
- Numeric Rating Scale (NRS) pain score of 5 or higher
Exclusion Criteria:
- History of spinal surgery
- Cervical spondylolisthesis
- Spinal stenosis
- Presence of a neurological deficit
- History of psychiatric disease
- Polyneuropathy
- History of spinal fracture
- Pregnancy
- History of malignancy
- Known allergy to any medication used in the study
- Central sensitization
- Widespread pain
- Regional pain associated with a systemic disease
