A patient reports the recent onset of acute neck pain that radiates to the dorsum of the right forearm. Examination findings include a positive result on the Spurling neck compression test and pain with right cervical side bending. Which of the following interventions would be MOST appropriate for the patient?

• A. Manual cervical traction
• B. Cervical range of motion exercises
• C. Strengthening of the cervical flexors
• D. Application of a heat pack to the cervical spine

Answer: (A)

Acute cervical radiculopathy with a positive Spurling test means a nerve root is being compressed in the neck. The priority is to relieve that compression to reduce radiating pain and improve function. Manual cervical traction provides longitudinal distraction of the cervical spine, which helps open the neural foramina and decrease pressure on the affected nerve root. This direct decompression is why it’s the most appropriate initial intervention.

Cervical range of motion exercises could irritate the nerve root in the acute phase by loading the compressed structures. A heat pack may offer symptomatic relief from muscle tension but doesn’t address the underlying nerve root compression. Strengthening the cervical flexors doesn’t target the radicular symptoms and isn’t appropriate while radiculopathy is present.