Hypoalgesic Effect of Median Nerve Neural Mobilization Compared to a Controlled Group

Hypoalgesic Effect of Median Nerve Neural Mobilization in Cervicobrachial Pain Compared to a Controlled Group

The purpose of these study is to compare the effectivity of the Median Nerve Neural Mobilization technique to the complete absence of treatment in a group of patients who suffer cervicobrachial pain.

Median Nerve Neural Mobilization (MNNM) is a non invasive physical therapy technique that achieves pain relief through mechanical stimulation of the Median Nerve and the brachial plexus. It is believed that the hypoalgesic effect offered by the neural tissue mobilization procedure is a consequence of descending nervous system pain modulation activity and an improvement in the distinct biomechanical and sensitive properties of the involved neural tissue. The neural tissue mobilization procedure is associated to an increase in nerve mobility, edema, inflammation and intraneural pressure reduction without any known side effects when applied properly which is an important contrast to the wide variety of side effects caused by commonly used drug therapy to treat cervicobrachial pain.

Despite the crescent interest among the scientific community in evidence based options to treat pain there is a current lack of enough controlled double blind clinical trials that measure the effectiveness of neural tissue mobilization techniques such as the (MNNM) and its specific effect over cervicobrachial pain. For this reason the present investigation consisted in the application of a treatment protocol based on Median Nerve Neural Mobilization in a controlled double blind clinical trial with the aim to assess its clinical effectiveness in treating pain symptoms.

Inclusion Criteria:

• Clinical diagnosis of cervicobrachial pain confirmed by magnetic resonance imaging
• Presence of unilateral symptoms of arm pain, paresthesia or numbness in the upper extremity during at least 3 continuous months previous to the application of treatment.
• Positive results in all of the following tests: Spurling, Distraction, and Upper Limb

Exclusion Criteria:

• Contraindication in the use of nonsteroidal anti-inflammatory drugs (NSAIDs)
• The use of any type of treatment, therapy, procedure or drug to relieve pain
• Patients who are under anticonvulsant, antidepressant or psychotropic medication
• Vertebral instability
• Vertebral osteoporosis
• Vertebral or spine infection.
• Neurologic diseases of genetic, infectious or neoplastic origin
• Cervical stenosis myelopathy
• Pregnancy
• Kinesiophobia
• Endocrine disorders and menopause
• History of spine surgery
• Intellectual disability, severe mental illness, intoxication, severe sleep deprivation, Alzheimer's disease.