Multimodal Physiotherapy for Cervical Disc Herniation: A Case Report

Ainindia Khoiridatul Ilmiyah; Diah Rosyida Maulidina; Yeni Tri Nurhayat

doi:10.24843/

Authors

Ainindia Khoiridatul Ilmiyah Diploma in Physiotherapy Program, Faculty of Health Sciences, Universitas Muhammadiyah Lamongan, Lamongan, East Java, Indonesia Author
Diah Rosyida Maulidina Department of Physiotherapy, Faculty of Health Sciences, Universitas Muhammadiyah Lamongan, Lamongan, East Java, Indonesia Author
Yeni Tri Nurhayat Diploma in Physiotherapy Program, Faculty of Health Sciences, Universitas Muhammadiyah Lamongan, Lamongan, East Java, Indonesia Author

DOI:

https://doi.org/10.24843/

Keywords:

Cervical Disc Herniation, Transcutaneous Electrical Nerve Stimulation, Ultrasonic Therapy, McKenzie Method, Exercise Therapy, Shoulder Pain

Abstract

Background: Cervical disc herniation is a common cause of neck pain, reduced cervical mobility, muscle weakness, and functional disability. Multimodal physiotherapy may provide comprehensive benefits by addressing pain, movement limitation, and muscle dysfunction simultaneously.

Objective: To evaluate the effects of a multimodal physiotherapy program consisting of Transcutaneous Electrical Nerve Stimulation (TENS), therapeutic ultrasound, McKenzie exercises, and scapular strengthening in a patient with cervical disc herniation at the C5–C6 level.

Methods: A single case report was conducted on a 59-year-old male diagnosed with cervical disc herniation. The patient received four physiotherapy sessions including TENS (100 Hz, 100 μs, 10–15 minutes), ultrasound therapy (1 MHz, 1.5 W/cm², continuous mode, 5 minutes), McKenzie exercises, and scapular strengthening exercises. Outcomes included Numeric Rating Scale (NRS), cervical range of motion (ROM), Manual Muscle Test (MMT), Neck Disability Index (NDI), and Shoulder Pain and Disability Index (SPADI). Data were analyzed descriptively by comparing pre- and post-intervention findings.

Results: After four treatment sessions, pain decreased from 7/10 to 3/10 on the NRS. Cervical ROM improved by 15–20° across movement directions. Muscle strength increased from MMT grade 3 to grade 4. NDI decreased from 46% to 24%, while SPADI decreased from 60% to 32%. Statistical testing, p values, and confidence intervals were not applicable due to the single-case design.

Conclusion: A multimodal physiotherapy approach combining TENS, ultrasound, McKenzie exercises, and scapular strengthening produced clinically meaningful improvements in pain, cervical ROM, muscle strength, and functional outcomes in a patient with cervical disc herniation.