Comparison of conservative treatment with and without neural mobilization for patients with low back pain: A prospective, randomized clinical trial

Abstract

BACKGROUND: Low back pain (LBP) is a common problem that causes pain, disability, and gait and balance problems. Neurodynamic techniques are used in the treatment of LBP. OBJECTIVE: The aim of this study was to compare the effects of electrotherapy and neural mobilization on pain, functionality, gait, and balance in patients with LBP. MATERIALS AND METHODS: A total of 41 patients were randomly assigned to either the neural mobilization group (NMG, n= 20) or electrotherapy group (ETG, n= 21). Assessment tools used were Visual Analogue Scale (VAS) for pain, Oswestry Disability Index (ODI) for functionality, straight leg raise test (SLRT) for neural involvement, and baropedographic platform (Zebris FDM-2TM) for gait and static balance measurements. RESULTS: Both groups showed a significant decrease in pain and functional disability, while only the NMG group showed a significant increase in SLRT scores (p< 0.05). However, there were no statistically significant pre- to post-treatment changes in gait or static balance parameters in either group (p< 0.05). CONCLUSION: Neural mobilization was effective in reducing pain and improving functionality and SLRT performance in patients with LBP, but induced no change in gait and static balance parameters. Neural mobilization may be used as self-practice to supplement standard treatment programs.

Effectiveness of neural mobilization on pain intensity, disability, and physical performance in adults with musculoskeletal pain—A protocol for a systematic review of randomized and quasi-randomized controlled trials and planned meta-analysis

“…Although NM has shown some positive effects in treating people with musculoskeletal pain [ 6 – 9 ], previous systematic reviews have shown limited or inconclusive evidence to support the use of this intervention in these population. As stated before, most previous reviews have focused only on specific musculoskeletal conditions or only on limited outcomes of interest, with a narrow approach of the NM application [ 17 , 46 – 51 ], with the exception of three of them [ 14 , 16 , 18 ].…”

“…A therapeutic intervention that has been applied to treat patients with musculoskeletal conditions is neural mobilization (NM), which has shown positive effects in reducing pain and improving functioning [ 6 – 9 ]. NM consists of combinations of joint movements that promote the gliding or the tensioning of the neural tissue and that can be performed both passively by the health professional or actively by the individual [ 10 – 13 ].…”

Hypoalgesic and Motor Effects of Neural Mobilisation versus Soft-Tissue Interventions in Experimental Craniofacial Hyperalgesia: A Single-Blinded Randomised Controlled Trial

“…In clinical practice, it is frequent to use a combination of several manual techniques, and the inclusion of the NM to other OMPT or SST techniques has also been studied among the craniofacial region [ 65 ]. It has been shown that the addition of NM to the OMT techniques may obtain greater therapeutic effects of pain reduction among cervical radiculopathy patients [ 27 , 66 , 67 ]. It is theorised that NM may restore nerve homeostasis by mobilisation (passive or active) of the nerves and surrounding structures of the nervous system [ 24 ].…”

Effects of adding neural mobilization to traditional physical therapy on pain, functional disability, and H-reflex in patients after lumbar laminectomy: A randomized controlled trial

“…The results of this study are in line with previous studies which reported that neural mobilization techniques improved pain and function in patients with nerve related low back pain. 1,15–17 Additionally, neural mobilization has been reported as a superior post-surgical intervention compared with myofascial release and lumbar stabilization exercises alone in improving pain and functional disability after lumbar spinal fusion. 18…”