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

J Man Manip Ther. 2023 Feb;31(1):4-12. doi: 10.1080/10669817.2022.2065599. Epub 2022 May 18.

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; low back pain; nerve root; radicular; sciatica.

Publication types

  • Systematic Review

MeSH terms

  • Humans
  • Low Back Pain* / therapy
  • Musculoskeletal Pain*
  • Physical Therapy Modalities