Efficacy of Cervical Spine Mobilization Versus Peripheral Nerve Slider Techniques in Cervicobrachial Pain Syndrome– A Randomized Clinical Trial

Neck pain is a common disorder affecting 57% of the German population 1 , and, combined with low back pain, it results in costs of nearly 3.3 billion euros 2 . A number of studies show moderate to good evidence that manual therapy may alleviate neck pain 3-7 . This analgesic effect may not only be explained by traditional approaches such as the Gate-Control-Theory 8 and reduced peripheral afferent discharge 9 but also by the activation of central nervous pain mechanisms such as the periaqueductal gray, which seems to be responsible for pain control and modulation of autonomic functions 10-12 . In addition to pain alleviation, the increase in joint range of motion is an intention in manual therapy 7, 12-13 . Furthermore, manual mobilization techniques seem to positively influence neurodynamics 14-15 . If neck pain radiates into the arm, it is named cervicobrachial pain syndrome and is often associated with neural tissue dysfunctions 16 . Such dysfunctions are caused by changes in both the physiology and mechanics of ABSTRACT