Neural mobilization in low back and radicular pain: a systematic review

ABSTRACT

Background

Low back pain can present with radicular pain caused by lumbosacral nerve root pathology. Neural mobilization (NM) is a treatment technique used to treat low back and radicular pain (LBRP).

Purpose

To evaluate the effectiveness of NM interventions in improving pain, disability, and function in adults with LBRP.

Data Sources

CINAHL Plus, MEDLINE (Ovid), Physiotherapy Evidence Database, and Cochrane databases were searched.

Study Selection

Randomized controlled trials assessing the effect of NM on pain, disability, and/or function in adults with LBRP.

Data Extraction

Authors reviewed studies and used the PEDro scale and the revised Cochrane risk-of-bias tool to assess methodological quality and risk of bias.

Data Synthesis

Eight studies were included. Six of the eight studies found the addition of NM to conservative treatment improved all measured outcomes. One study found improvements in some but not all functional measures, and delayed improvements in pain. One study found improvements in measures of neural sensitivity, but not overall pain and disability.

Conclusions

NM may be an effective tool for short-term improvements in pain, function, and disability associated with LBRP. Additional high quality research is needed.

Study registration

: This systematic review protocol was registered with PROSPERO (registration number: CRD42020192338).

KEYWORDS:

• Neural mobilization
• nerve root
• low back pain
• sciatica
• radicular

Notes on Contributors

Mica Peacock earned her Bachelor of Arts in Biology from Reed College, and received her Doctor of Physical Therapy degree at Samuel Merritt University.

Samuel Douglas received his Bachelor of Arts in Neuroscience and Behavior from Wesleyan University, and received his Doctor of Physical Therapy degree at Samuel Merritt University.

Preeti Nair earned her Bachelor of Physiotherapy at Pune University in India. She then earned a PhD in Rehabilitation Sciences at the University of Florida, with a research focus on Biomechanics and Neurophysiology of walking in individuals with neurological impairment. She is currently an Associate Professor in the Department of Physical Therapy at Samuel Merritt University.

Supplementary material

Supplemental data for this article can be accessed here.

Disclosure statement

Authors report no conflict of interest.