Median Nerve Neural Mobilization Adds No Additional Benefit When Combined with Cervical Lateral Glide in the Treatment of Neck Pain: A Randomized Clinical Trial.

Daniel Martin-Vera,Cesar Calvo-Lobo,David Rodríguez-Sanz,Ibai López-De-Uralde-Villanueva,Alberto Arribas-Romano,Daniel Pecos-Martín,Josué Fernández-Carnero,Pedro Martínez-Lozano

doi:10.3390/jcm10215178

Abstract

Background: This study aimed to compare the effectiveness of cervical lateral glide (CLG) added to median nerve neural mobilization (MNNM) in patients with neck pain (NP). Methods: A single-blinded randomized controlled clinical trial was carried out in a Pain Management Unit from a Hospital. A total sample of 72 patients with NP was recruited from a hospital. Patients were randomized to receive isolated CLG (n = 36) or CLG + MNNM (n = 36). Bilateral elbow extension range of motion (ROM) on upper limb neurodynamic test 1 (ULNT1), bilateral pressure pain thresholds (PPT) on the median nerve at elbow joint, C6 zygapophyseal joint and tibialis anterior, Visual analogue scale (VAS), body chart distribution of pain, active cervical ROM (CROM), Neck Disability Index (NDI), and Tampa Scale of Kinesiophobia (TSK-11) were measured at baseline as well as immediately, 15 days, and 1 month after treatment. Results: There were no statistically significant interactions (p > 0.05) between treatment and time for median nerve mechanosensitivity outcomes, pain intensity, symptom distribution, and PPT of the widespread pain assessment, as well as cervical function, and kinesiophobia. Conclusions: MNNM gave no additional benefit to CLG in patients with NP regarding pain intensity, symptom distribution, mechanosensitivity, functionality, and kinesiophobia. Only two treatment sessions and the short follow-up are important issues, therefore, justifying further studies to answer the research question with better methodology.

Highlights

Neck pain (NP) is a common disabling condition that is likely to affect most people at some time in their lives [1,2,3]
The study protocol was conducted from April to June of 2017 as an interventional phase II, parallel, single-blind, randomized controlled clinical trial
36 subjects completed the study in the cervical lateral glide (CLG) group and 36 CLG + median nerve mobilization (CLG + MNM) group

Summary

Introduction

Neck pain (NP) is a common disabling condition that is likely to affect most people at some time in their lives [1,2,3]. Different interventions have been proposed for nociceptive [10,11] and neuropathic [12,13,14] NP, there is low evidence to determine the effectiveness of physical medicine modalities, such as neural mobilization, and high quality randomized clinical trials are necessary for patients with NP [15,16]. Added to median nerve neural mobilization (MNNM) in patients with neck pain (NP). Results: There were no statistically significant interactions (p > 0.05) between treatment and time for median nerve mechanosensitivity outcomes, pain intensity, symptom distribution, and PPT of the widespread pain assessment, as well as cervical function, and kinesiophobia. Conclusions: MNNM gave no additional benefit to CLG in patients with NP regarding pain intensity, symptom distribution, mechanosensitivity, functionality, and kinesiophobia. Two treatment sessions and the short follow-up are important issues, justifying further studies to answer the research question with better methodology

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