Home-Based Exercise After Cervical Epidural Steroid Injection for Cervical Radiculopathy
Effect of a Home-Based Exercise Program After Cervical Interlaminar Epidural Steroid Injection on Clinical Outcomes in Patients With Chronic Cervical Radiculopathy: A Randomized Controlled Trial
Necmettin Erbakan University
60 participants
Feb 1, 2026
INTERVENTIONAL
Conditions
Summary
Cervical radiculopathy is a common cause of neck and arm pain resulting from compression or inflammation of a cervical nerve root. Cervical epidural steroid injection is frequently used to reduce pain and improve function in patients who do not respond to conservative treatment. However, long-term functional recovery may require additional rehabilitation strategies. This randomized controlled trial aims to investigate whether adding a standardized home-based exercise program after cervical interlaminar epidural steroid injection improves pain, disability, sleep quality, and quality of life in patients with chronic cervical radiculopathy. Participants will be randomly assigned to receive either injection alone or injection followed by an eight-week home-based exercise program.
Eligibility
Inclusion Criteria6
- Age between 18 and 70 years.
- Chronic cervical radicular pain lasting ≥3 months, characterized by neck pain with accompanying arm pain consistent with a cervical nerve root distribution.
- Average pain intensity ≥4/10 on the Numeric Rating Scale (NRS) over the preceding 7 days at baseline.
- Diagnosis of chronic cervical radiculopathy due to cervical disc herniation, confirmed by clinical examination and cervical MRI findings at the corresponding level.
- Insufficient response to conservative treatment, including physical therapy, medication, and/or exercise therapy.
- Ability to provide written informed consent and comply with study procedures.
Exclusion Criteria8
- Patients were excluded if any of the following were present:
- Clinical signs of cervical myelopathy or progressive neurological deficit.
- Suspicion of serious spinal pathology (e.g., infection, malignancy).
- Contraindications to epidural steroid injection, including uncontrolled coagulopathy, anticoagulant therapy not appropriately managed, or local/systemic infection.
- Pregnancy.
- Prior cervical spine surgery or cervical epidural steroid injection within the prespecified washout period.
- Severe musculoskeletal or neurological comorbidities that could interfere with safe participation in the exercise program.
- Discordance between clinical symptoms and imaging findings.
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Interventions
Fluoroscopy-guided cervical interlaminar epidural steroid injection performed at the C7-T1 interlaminar space using a paramedian approach. Epidural placement is confirmed with contrast medium under fluoroscopic visualization. A total of 8 mg dexamethasone is injected into the epidural space to reduce inflammation and nerve root irritation associated with cervical radiculopathy.
Participants perform a standardized home-based neck exercise program initiated after cervical epidural steroid injection and continued for 8 weeks. The program includes cervical mobility exercises, isometric strengthening exercises, deep cervical muscle activation, and stretching exercises targeting the upper trapezius and levator scapulae muscles. Exercises are performed five days per week for approximately 15-20 minutes per session. Participants receive initial supervised instruction and a printed exercise brochure to facilitate correct performance and adherence.
Locations(1)
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NCT07506785