Effects of Median Nerve Neural Mobilization in Treating Cervicobrachial Pain

There is a current lack of sufficiently high-quality randomized controlled clinical trials that measure the effectiveness of neural tissue mobilization techniques such as median nerve neural mobilization (MNNM) and their specific effects on cervicobrachial pain (CP). This study aim was to compare the effectiveness of MNNM in subjects with CP versus a waiting list control group (WLCG).

A single-blinded, parallel, randomized controlled clinical trial was performed. Subjects were recruited with a medical diagnosis of CP corroborated by magnetic resonance imaging. In total, 156 individuals were screened, 60 subjects were recruited, and 51 completed the trial. Pain intensity reported using the Numeric Rating Scale for Pain (NRSP; primary outcome), cervical range of motion (CROM) and functionality using the Quick-DASH scale were the outcome measurements. Assessments were conducted at baseline and 1-hour after treatment (1, 15 and 30 intervention days). Therefore, MNNM was implemented with 30-days of follow-up.

The NRSP values of the MNNM group were significantly (p<0.0001; 95% CI) superior to those obtained in the WLCG. Subjects treated with MNNM reported an NRSP decrease of 3.08 points at discharge. CROM and Quick-DASH outcome values were significantly (p˂0.0001; 95%CI) improved only in the MNNM group. Hedges’ g showed a very large effect of the MNNM intervention. MNNM may be superior to no treatment in reducing pain and increasing function in the affected upper limb of subjects with CP. 

Sensorimotor Impairment in Neck Pain

Join Chris Worsfold in this short online course to learn about the evaluation and rehabilitation of sensorimotor impairment in patients with neck pain.