A common question posed to those of us treating cervical herniated discs is the role of physical therapy as a way to treat the herniated disc. The other modalities that frequently come into question are the role of manual therapy or traction. The bone and joint task force on neck pain and its associated disorders published in European Spine in 2008 by Hurwitz, Carroll LJ et al. determined that manual therapy and exercise did seem to provide some benefits to patients with cervical radiculopathy (pain, numbness or tingling down the arm) while traction and various passive modalities did not offer benefit beyond usual care. In our own experience, we find Physical Therapy useful in those patients who have either preoperatively and/or postoperatively developed specific muscle weakness. Many of those patients end up having surgery, but physical therapy does play an important role in the return of muscle strength. Although to the best of our knowledge, we know no randomized trial evaluating the effects of physical therapy during the postoperative period following cervical spine surgery.
Jack Stern, MD PhD