What is the role of a cervical collar in the treatment of acute cervical radiculopathy?

Updated: Oct 08, 2018
  • Author: Gerard A Malanga, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Answer

In addition, a cervical collar can be used for patient comfort and some support. A cervical pillow at night can be helpful in maintaining the neck in a neutral position and limiting head positions that cause narrowing of the neural foramen. Manual and, if necessary, mechanical traction can be used to reduce radicular symptoms by decreasing foraminal compression and intradiscal pressures.

Kuijper et al found that, with patients in the early phase of cervical radiculopathy, the use of a semi-hard cervical collar and rest for 3-6 weeks, or physiotherapy accompanied by home exercises for 6 weeks, reduced neck and arm pain substantially compared with a wait-and-see policy. [27] In a randomized controlled trial in 205 patients with symptoms and signs of cervical radiculopathy of less than 1 month's duration, neck pain did not decrease significantly in the first 6 weeks, whereas the cervical collar and rest resulted in a 17-mm reduction on the visual analogue scale and physiotherapy resulted in a decrease of 14 mm. The neck disability index showed a significant change with the use of the collar and rest and a nonsignificant effect with physiotherapy and home exercises, compared with a wait-and-see policy. [27]

Most studies of modalities such as electrical stimulation have been uncontrolled. Although these modalities appear to be helpful in reducing the associated muscle pain and spasm that are often found with cervical problems, they should be limited to the initial pain control phase of treatment.


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