Rehabilitation of Chronic Cervical Spondylolysis with Carpal Tunnel Syndrome using a Multimodal Physiotherapy Approach: A Case Study

Abstract

Background: Chronic cervical spondylolysis is a degenerative musculoskeletal condition often associated with neck pain, restricted mobility, and neurological symptoms due to nerve root involvement. When accompanied by carpal tunnel syndrome, patients may experience compounded functional impairment, including upper limb pain, paresthesia, and reduced hand function. Managing such coexisting conditions requires a comprehensive and individualized rehabilitation strategy. Objective: This case study aimed to evaluate the effectiveness of a multimodal physiotherapy approach in reducing pain, improving functional mobility, and enhancing upper limb function in a patient with chronic cervical spondylolysis and concurrent carpal tunnel syndrome. Methods: A patient presenting with chronic neck pain, radiating upper limb symptoms, and clinically diagnosed carpal tunnel syndrome underwent a structured physiotherapy program over a defined intervention period. The multimodal rehabilitation protocol included therapeutic exercises, cervical stabilization training, neural mobilization, manual therapy, postural correction, ergonomic education, and electrotherapy modalities for pain management. Outcome measures included pain intensity, cervical range of motion, hand grip strength, functional status, and patient-reported symptom severity. Results: Post-intervention findings demonstrated a significant reduction in pain intensity, improved cervical mobility, enhanced hand function, and decreased paresthesia. Functional performance and daily activity tolerance improved notably, with the patient reporting better postural awareness and reduced symptom recurrence. Conclusion: A multimodal physiotherapy approach appears to be an effective conservative management strategy for individuals with coexisting chronic cervical spondylolysis and carpal tunnel syndrome. Integrated rehabilitation targeting both cervical and peripheral nerve dysfunction may lead to meaningful improvements in pain, mobility, and functional independence. Further studies with larger samples are recommended to support these findings.