Transcutaneous Electrical Nerve Stimulation Versus Repetitive Transcranial Magnetic Stimulation on Pain and Functional Outcome in Cervical Radiculopathy

NCT07557511 | Not Yet Recruiting

• 1 other identifier: P.T.REC/012/006350
• Study Type: interventional
• Target: 50
• Locations: 0 countries
• Sites: N/A

Brief Summary

this study will be conducted to compare between transcutaneous electrical nerve stimulation versus repetitive transcranial magnetic stimulation on pain and functional outcome in cervical radiculopathy

Conditions

Cervical Radiculopathy

Keywords

Transcutaneous Electrical Nerve Stimulation; Repetitive Transcranial Magnetic Stimulation; pain; functional outcome; cervical radiculopathy

Outcome Measures

Primary Outcomes (3)

• pain intensity

  it will be measured using neumerical pain rating scale (NPRS), There are 11 components in total, with a scoring range from 0 to 10, where 0 signifies the absence of pain, and 10 indicates the highest level of pain.

  up to 6 weeks

• neck disability

  it will be measured using Neck disability index. It consists of a series of questions related to various activities, and the patient rates their level of difficulty in performing each activity on a scale from 0 to 5 where grade 0 represents no to negligible symptoms and grade 5 represents severe symptoms. The total score will be then calculated and converted into a percentage with higher scores indicating greater disability and limitations due to neck pain. 0-20% indicates normal condition, 21-40% indicates mild disability, 41-60% indicates moderate disability, 61-80% indicates severe disability, and more than 80% indicates exaggerated dis ability.

  up to 6 weeks

• sympathetic skin response

  The sympathetic skin response is a measurement of the electrical potential generated by sweat glands in response to a stimulus, indicating sympathetic nervous system activity. SSR has been proposed as a non-invasive approach to investigate the function of the sympathetic system. it will be measured by electromyography device. Normal, resting adult values are commonly defined by a hand latency of 1.3-1.5 seconds, foot latency of 1.9-2.1 seconds, and an amplitude greater than 1 mV in the hand and 0.2 mV in the foot.

  up to 6 weeks

Secondary Outcomes (1)

• cervical range of motion

  up to 6 weeks

Study Arms (2)

Transcutaneous Electrical Nerve Stimulation

EXPERIMENTAL

25 of cervical radiculopathy patients will participated in this group. They will receive peripheral nerve stimulation by using TENS (80-150ms) for 20 min. After that they will underwent the conventional physical therapy session for 3 days a week for 6 weeks

Other: Transcutaneous Electrical Nerve Stimulation

repetitive Transcranial Magnetic Stimulation

EXPERIMENTAL

25 of cervical radiculopathy patients will participated in this group. They will receive cranial stimulation by using rtms 10 Hz frequency (90% rMT) for 20-minute duration (each trial includes 20 pulses in 2 seconds and 8 seconds intertrain interval). This process was repeated for three sessions in three consecutive days for 6 weeks

Other: repetitive Transcranial Magnetic Stimulation

Interventions

Transcutaneous Electrical Nerve Stimulation OTHER

patients will receive TENS to relieve peripheral radiating pain, with high frequency (80 Hz), low intensity (as per the patient's comfort but will not be painful and not elicit the muscle contraction) and a pulse width of 150 µs of asymmetrical biphasic rectangular waveforms, will be used for 20 min+ cinventional therapy in the form of Moist Heat followed by cervical traction in a seated position manually followed by nerve glides and Chin Tuck exercises

Transcutaneous Electrical Nerve Stimulation

repetitive Transcranial Magnetic Stimulation OTHER

Participants will be seated in an rTMS chair with a head and armrest. The resting motor threshold (rTMS) will be defined using visual observation of muscle twitch , For this method, rTMS Applied at Primary Motor Cortex (M1): The stimulation is applied over the M1 region contralateral to the side of pain. Frequency: High-frequency rTMS, typically at 10 Hz, is employed to enhance cortical excitability. the patient's hand will be placed on the armrest and rMT will be set as the lowest setting at which ≥10 of 20 stimuli resulted in any observable contraction of the right thumb (abductor pollicis brevis \[ABP\]muscles). The rTMS system was set on 10 Hz frequency (90% rMT), (900 pulses \[45 trials\] were delivered to the right motor cortex \[position C4\] or 900 pulses \[45 trials\] were delivered to the left motor cortex \[position C3\]), and 20-minute duration (each trial includes 20 pulses in 2 seconds and 8 seconds.plus conventional therapy

repetitive Transcranial Magnetic Stimulation

Eligibility Criteria

• Age: 30 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• patients will be from both sexes, aged between (30 to 45) years
• patients will be diagnosed as cervical radiculopathy unilateral upper limb pain radiating in C5,6 and C6,7 in the lateral aspect of the arm, forearm and hand for at least 3 months sensory in nature. (Sharma et al., 2025).
• The Neck Disability Index (NDI) NDI more than 20%.
• body mass index (BMI) was (18.5 to 29.9) Kg/m2.
• Numeric Pain Rating Scale (NPRS) score \> 6 y

You may not qualify if:

• Patients with a history of injury to the cervical spine.
• Patients who underwent cervicothoracic spine surgery, motor manifestations , spinal canal stenosis, bilateral symptoms, upper motor neuron impairments.
• Use of steroids and pharmacological therapy.
• Any congenital anomaly like cervical rib.
• Pregnancy, oncological episodes.
• The presence of a pacemaker, cochlear implant.
• Epilepsy, psychotropic drug intake before admission, neurological disorders (such as stroke and plexopathies),

Sponsors & Collaborators

• Cairo University: lead

MeSH Terms

Conditions

Radiculopathy; Pain

Interventions

Transcutaneous Electric Nerve Stimulation; Transcranial Magnetic Stimulation

Condition Hierarchy (Ancestors)

Peripheral Nervous System Diseases; Neuromuscular Diseases; Nervous System Diseases; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Electric Stimulation Therapy; Therapeutics; Physical Therapy Modalities; Rehabilitation; Analgesia; Anesthesia and Analgesia; Magnetic Field Therapy

Central Study Contacts

rania barseem, master

CONTACT

01068207592; raniafathy141986@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: opaque sealed envelope
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: principle investigator : Rania fathy mustafa barseem

Model Details: Transcutaneous Electrical Nerve Stimulation andRepetitive Transcranial Magnetic Stimulation

Study Record Dates

• First Submitted: April 23, 2026
• First Posted: April 29, 2026
• Study Start: April 30, 2026
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): August 1, 2026
• Last Updated: April 29, 2026

Record last verified: 2026-04