Cervical RadiculopathyCRNCT07557511
Transcutaneous Electrical Nerve Stimulation Versus Repetitive Transcranial Magnetic Stimulation on Pain and Functional Outcome in Cervical Radiculopathy
A study testing Transcutaneous Electrical Nerve Stimulation and repetitive Transcranial Magnetic Stimulation in people with Cervical Radiculopathy, run by Cairo University.
Trial 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 Read more about this study
- Who is it for?
- Ages 30 to 45 years
- Conditions the study is for
- Cervical Radiculopathy
- What is being tested?
- Transcutaneous Electrical Nerve Stimulation and repetitive Transcranial Magnetic Stimulation
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 50 participants
- Where
- No sites listed yet
- Study dates
- 30 Apr 2026to 1 Aug 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 30 to 45 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- 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
Who cannot join
- 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),
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
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
Read the detailed description
Cervical Radiculopathy mostly occurs due to mechanical or inflammatory stimuli around the cervical nerve roots which is either due to disc herniation or osteophytes formation causing nerve root compression, inflammation or both but sometimes It can also be caused due to tumors, trauma, synovial cysts, meningeal cysts, dural arteriovenous fistula or tortous vertebral arteries.Transcutaneous electrical nerve stimulation (TENS) is a type of electrical stimulation which mostly aims for the symptomatic pain relief by stimulating the sensory nerve fibers either by pain gate mechanism or opioid system. As proposed by gate control theory, TENS produces an activation of inhibitory interneurons in the substantia gelatinosa in the dorsal horn of the spinal cord by the electric stimulation of large diameter fibres(A-beta -fibres), which inhibit the transmission of nociceptive signals from small diameter fibres (A delta and C) and as per opioid mechanism , it stimulates the release of endorphin, leading to vasodilation in the injured tissue.
Alternative non-pharmacological interventions using neuromodulation techniques have been proposed. Among them, repetitive transcranial magnetic stimulation (rTMS) applied over the primary motor cortex (M1) is the neuromodulation technique with the highest level of evidence, in the third- line treatment, to alleviate chronic neuropathic pain.
Owing to the limitations of current interventions, researchers are investigating the use of noninvasive brain stimulation techniques, such as repetitive transcranial magnetic stimulation (rTMS), in chronic pain management. rTMS holds promise because of its ability to modulate cortical activity, which in turn can help manage chronic pain. High-frequency rTMS applied to the motor cortex contralateral to the side of the worst pain has been shown to be effective in inducing analgesia (pain relief) in various pain conditions including fibromyalgia, neuropathic pain, migraine, and chronic low back pain (CLBP) .Therefore, the purpose of this study was to evaluate whether targeting both the central (via rTMS) and the peripheral nervous system (via TENS) leads to increased pain relief, decreased functional disability, and improved quality of life compared with targeting both the peripheral and central nervous system in patients with cervical radiculopathy.
- Conditions
- Cervical Radiculopathy
- Being tested
- Transcutaneous Electrical Nerve Stimulation, repetitive Transcranial Magnetic Stimulation
- Keywords
- Transcutaneous Electrical Nerve Stimulation, Repetitive Transcranial Magnetic Stimulation, pain, functional outcome, cervical radiculopathy
- Medical subject headings
- Radiculopathy, Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Transcutaneous Electrical Nerve StimulationOther
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
repetitive Transcranial Magnetic StimulationOther
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
| Study group | Role | What they receive |
|---|---|---|
| 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 Receives: 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 Receives: Other: repetitive Transcranial Magnetic Stimulation |
What is being measured
The primary outcome is the main question the study is designed to answer.
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.
Measured: 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.
Measured: 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.
Measured: up to 6 weeks
Secondary outcomes (1)
cervical range of motion
cervical range of motion device will be used to assess cervical range of motion
Measured: up to 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Apr 2026
- Study start30 Apr 2026 (estimated)
- Primary completion1 Aug 2026 (estimated)
- Study completion1 Aug 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Cervical RadiculopathyStudies of the same condition, open and under way.
- More trials run by Cairo UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Transcutaneous Electrical Nerve Stimulation andRepetitive Transcranial Magnetic Stimulation
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 50 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Rania Fathy Mustafa barseem, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07557511
- Sponsor's protocol ID
- P.T.REC/012/006350
- Acronym
- CR
- Status last verified
- Apr 2026
- First submitted
- 23 Apr 2026
- Last updated
- 29 Apr 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 29 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Transcutaneous Electrical Nerve Stimulation Versus Repetitive Transcranial Magnetic Stimulation on Pain and Functional Outcome in Cervical Radiculopathy
- ClinicalTrials.gov ID
- NCT07557511
- Acronym / sponsor ID
- CR / P.T.REC/012/006350
- Conditions
- Cervical Radiculopathy
- Keywords
- Transcutaneous Electrical Nerve Stimulation, Repetitive Transcranial Magnetic Stimulation, pain, functional outcome, cervical radiculopathy
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 50 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 30 Apr 2026 (estimated)
- Primary completion
- 1 Aug 2026 (estimated)
- Study completion
- 1 Aug 2026 (estimated)
- First posted
- 29 Apr 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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
Detailed description
Cervical Radiculopathy mostly occurs due to mechanical or inflammatory stimuli around the cervical nerve roots which is either due to disc herniation or osteophytes formation causing nerve root compression, inflammation or both but sometimes It can also be caused due to tumors, trauma, synovial cysts, meningeal cysts, dural arteriovenous fistula or tortous vertebral arteries.Transcutaneous electrical nerve stimulation (TENS) is a type of electrical stimulation which mostly aims for the symptomatic pain relief by stimulating the sensory nerve fibers either by pain gate mechanism or opioid system. As proposed by gate control theory, TENS produces an activation of inhibitory interneurons in the substantia gelatinosa in the dorsal horn of the spinal cord by the electric stimulation of large diameter fibres(A-beta -fibres), which inhibit the transmission of nociceptive signals from small diameter fibres (A delta and C) and as per opioid mechanism , it stimulates the release of endorphin, leading to vasodilation in the injured tissue.
Alternative non-pharmacological interventions using neuromodulation techniques have been proposed. Among them, repetitive transcranial magnetic stimulation (rTMS) applied over the primary motor cortex (M1) is the neuromodulation technique with the highest level of evidence, in the third- line treatment, to alleviate chronic neuropathic pain.
Owing to the limitations of current interventions, researchers are investigating the use of noninvasive brain stimulation techniques, such as repetitive transcranial magnetic stimulation (rTMS), in chronic pain management. rTMS holds promise because of its ability to modulate cortical activity, which in turn can help manage chronic pain. High-frequency rTMS applied to the motor cortex contralateral to the side of the worst pain has been shown to be effective in inducing analgesia (pain relief) in various pain conditions including fibromyalgia, neuropathic pain, migraine, and chronic low back pain (CLBP) .Therefore, the purpose of this study was to evaluate whether targeting both the central (via rTMS) and the peripheral nervous system (via TENS) leads to increased pain relief, decreased functional disability, and improved quality of life compared with targeting both the peripheral and central nervous system in patients with cervical radiculopathy.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Transcutaneous Electrical Nerve Stimulation andRepetitive Transcranial Magnetic Stimulation
| Arm | Type | Receives |
|---|---|---|
| Transcutaneous Electrical Nerve Stimulation | Experimental | Other: Transcutaneous Electrical Nerve Stimulation25 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 |
| repetitive Transcranial Magnetic Stimulation | Experimental | Other: repetitive Transcranial Magnetic Stimulation25 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 |
Who may qualify
- Ages
- 30 to 45 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- 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
Key exclusion criteria (7 listed)
- 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.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Transcutaneous Electrical Nerve Stimulationpatients 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 | Other | Transcutaneous Electrical Nerve Stimulation |
| repetitive Transcranial Magnetic StimulationParticipants 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 | Other | repetitive Transcranial Magnetic Stimulation |
Primary outcome
pain intensity
Time frame: up to 6 weeks
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.
neck disability
Time frame: up to 6 weeks
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.
sympathetic skin response
Time frame: up to 6 weeks
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.
1 secondary outcome
cervical range of motion
Time frame: up to 6 weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Apr 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Questions about this trial
What is this clinical trial studying?
A study testing Transcutaneous Electrical Nerve Stimulation and repetitive Transcranial Magnetic Stimulation in people with Cervical Radiculopathy, run by Cairo University.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 29 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact rania barseem, master (01068207592, raniafathy141986@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
pain intensity (time frame: up to 6 weeks). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Apr 2026.