Objective To clarify the mechanism of action of the Cervical Rotation-Traction Manipulation in treating cervical spondylotic radiculopathy using shear wave elastography.

Methods Thirty patients with cervical spondylotic radiculopathy and 30 volunteers without abnormal cervical conditions in the past three months were included. Patients received manipulation therapy once a week for 15 to 20 minutes, totaling three sessions over two weeks. Volunteers received no treatment. Shear wave elastography was the primary research method (with Young's modulus as the primary outcome measure) to assess the effect of the Cervical Rotation-Traction Manipulation on the neck and back soft tissues in patients with cervical spondylotic radiculopathy. Shear wave elastography was performed on patients three times: before treatment, after the first manipulation session, and after two weeks of treatment. Volunteers underwent one shear wave elastography test as a baseline control. Secondary outcome measures were the visual analogue scale (VAS) and neck disability index (NDI) scores of patients before treatment, after treatment, and two weeks after treatment.

Results The Young's modulus values of the cervical muscles in patients before treatment were higher than those in volunteers (P < 0.001), but there was no statistically significant difference after the treatment course. There were statistically significant differences in the Young's modulus of the muscle before and after treatment and before and after the treatment course in patients (P < 0.001). The Young's modulus values of the affected side cervical muscles were higher than those of the healthy side (P = 0.001), but there was no statistically significant difference after treatment. The median Young's modulus was positively correlated with the VAS score (r = 0.741, P < 0.001) and the NDI score (r = 0.591, P < 0.001) in patients with cervical spondylotic radiculopathy.

Conclusion The Cervical Rotation-Traction Manipulation can reduce the VAS and NDI scores of patients with cervical spondylotic radiculopathy, lower neck muscle tension, and balance the distribution of cervical muscle tension while reducing it. Young's modulus is a potential indicator reflecting the therapeutic effect of the spinal manipulation.