Resolution of Neck Pain and Recovery of Drug-associated Erectile Dysfunction Following Conservative Management in Cervical Spondylosis: A Case Report

Abstract

Cervical spondylosis is a degenerative disorder of the cervical spine that commonly causes chronic neck pain and functional limitations in older adults. Although pharmacologic therapy, including neuropathic pain agents, is usually the first line of management, it can cause adverse effects such as erectile dysfunction, which may limit its usefulness and necessitate conservative management like physiotherapy. A 67-year-old male civil servant presented with a six-month history of right-sided neck pain and a burning sensation that began after abrupt neck rotation during exercise. Radiographs showed osteophyte formation and straightening of the cervical lordosis. Medical management included Amlodipine, Neurovite, and the neuropathic pain agent Gabapentin, which provided minimal relief but triggered erectile dysfunction shortly after initiation, prompting discontinuation and referral for physiotherapy. The patient underwent eight physiotherapy sessions over four weeks, consisting of cervical mobilization (Grades II and III), soft-tissue mobilization, cryotherapy, progressive neck stabilization exercises, strengthening exercises, and ergonomic counseling. Following treatment, pain reduced (NPRS: 8/10 to 2/10), disability decreased (NDI: 27% to 8%), and the drug-induced erectile dysfunction completely resolved (IIEF-5: 10/25 to 25/25). Cervical range of motion improved across all planes, and no radicular signs were observed. This case highlights the role of structured physiotherapy in improving pain and function in cervical spondylosis and was associated with recovery of drug-related erectile dysfunction after medication cessation, although causality cannot be definitively established.