<b>Effects of Integrated Neuromuscular Inhibition Technique Combined with Neurodynamics on Pain, Range of Motion and Neck Disability in Patients with Cervical Radiculopathy</b>

Background: Cervical radiculopathy is a disabling musculoskeletal condition arising from mechanical or inflammatory nerve root compromise, often leading to pain, reduced cervical mobility, and functional disability. Conventional physiotherapy and neurodynamic mobilization provide some benefit, but the optimal strategy for achieving sustained improvement remains uncertain. Integrated Neuromuscular Inhibition Technique (INIT), which combines ischemic compression, strain counterstrain, and muscle energy, has emerged as a promising intervention targeting myofascial contributors to pain. Objective: To evaluate the effectiveness of INIT combined with neurodynamic mobilization compared with neurodynamic mobilization plus conventional physiotherapy in patients with cervical radiculopathy. Methods: A randomized controlled trial was conducted at Ghurki Trust Teaching Hospital, Lahore, enrolling 74 patients aged 35–50 years with unilateral cervical radiculopathy. Participants were randomized to INIT plus neurodynamic mobilization or conventional physiotherapy with neurodynamics for eight weeks. Primary outcomes were pain intensity (Numeric Pain Rating Scale), cervical range of motion (goniometry), and disability (Neck Disability Index). Assessments were performed at baseline, 4 weeks, and 8 weeks. Statistical analysis employed repeated-measures ANOVA and non-parametric equivalents, with effect sizes and 95% confidence intervals. Results: The experimental group achieved significantly greater improvements in pain (-1.6 points), disability (-7.4 points), cervical flexion (+4.9°), and rotation (+7.6°) at 8 weeks compared to controls (p < 0.001). Effect sizes ranged from moderate to large, confirming clinical relevance. Conclusion: INIT combined with neurodynamic mobilization provides superior pain reduction, functional recovery, and cervical mobility improvements compared to conventional physiotherapy with neurodynamics, supporting its use as an effective non-invasive treatment for cervical radiculopathy.