The clinical profile and assessment of cervical spine radiculopathy

Mansfield, Michael John (2024) The clinical profile and assessment of cervical spine radiculopathy. Doctoral thesis, University of East Anglia.

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Abstract

Background: Cervical spine radiculopathy (CSR) is a complex entrapment neuropathy that can result in changes in physical and mental health. Clinical practice is inconsistent in assessing CSR. This PhD research programme aimed to understand the clinical assessment practices when establishing CSR diagnosis.

Methods: Four studies were undertaken. Two systematic reviews reported CSR epidemiology and health outcomes. A mixed methods research study was grounded in a pragmatist paradigm and implemented an explanatory sequential design involving an online survey and qualitative interviews of United Kingdom (UK) physiotherapists. A case-control study assessed quantitative sensory testing and conditioned pain modulation of healthy control participants and people with CSR.

Results: CSR prevalence ranges from 1.07 to 1.76 per 1000 for males and 0.63 to 5.8 per 1000 for females. Poor health outcomes were associated with stress, depression, and anxiety symptoms. To diagnose CSR, manual muscle strength, light touch sensation, and reflex testing are most frequently used by UK physiotherapists. Pain screening tools or questionnaires and small-fibre somatosensory testing are less frequently used. Four qualitative themes contextualised the reasons underpinning the choices made when assessing CSR: perception of physiotherapist’s role in practice, service constraints, minimising risk, and understanding symptoms. Large and small nerve fibre somatosensory alongside psychosocial profiles of 25 healthy participants and four people with CSR were reported in the case-control study.

Conclusion: This PhD programme has enhanced the understanding and evidence for assessing people with CSR. The incidence and prevalence of CSR have been established, and the differences in assessment methods used have been reported. The association between mental health symptoms, such as depression, anxiety, and distress, and their negative impact on health outcomes have been discussed. The physiotherapy assessment strategies used and the basis for the decisions made when determining CSR have been identified. The PhD programme of research began to examine the somatosensory profiles of people with CSR and healthy control participants. Future studies examining prognosis indicators to develop the stratification of clinical assessment for people with CSR are recommended.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > School of Health Sciences
Depositing User:	Chris White
Date Deposited:	04 Mar 2025 08:33
Last Modified:	04 Mar 2025 08:33
URI:	https://ueaeprints.uea.ac.uk/id/eprint/98647
DOI:

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