National Physical Therapy Examination (NPTE) Practice Exam

Which combination of cervical motions is likely to provide the most pain relief for a patient with right-sided C4-C5 intervertebral foramen stenosis?

1. Right side bending and left rotation

2. Right side bending and right rotation

3. Left side bending and right rotation

4. Left side bending and left rotation

The correct answer is: Left side bending and left rotation

For a patient with right-sided C4-C5 intervertebral foramen stenosis, the goal is to alleviate pressure on the structures in that area. The most effective combination of cervical motions would generally involve positioning that reduces compression on the affected intervertebral foramen and the nerve roots that might be implicated. Left side bending and left rotation is likely to provide relief for a right-sided stenosis. This movement opens up the right intervertebral foramen, effectively creating more space for the nerves and reducing nerve root compression. By bending to the left, you create a wider space on the right side where the stenosis is located, which can relieve pain and discomfort. In contrast, combinations that involve right side bending or right rotation would tend to exacerbate the conditions causing compression in the right intervertebral foramen, leading to increased pain rather than relief. Understanding this biomechanical principle is critical for clinicians to promote effective therapeutic interventions for patients with cervical spinal issues.