Sustained natural apophyseal glide versus neurodynamic mobilization in the management of chronic unilateral discogenic cervical radiculopathy

Background: Cervical radiculopathy is a pathological condition of the cervical nerve root , causing sensory and motor deficits. The greater demand for neurological physical therapy identifies the need for more evidence-based techniques. Purpose: To compare the effect of neurodynamic mobilization versus sustained natural apophyseal glides in the management of patients with chronic discogenic unilateral cervical radiculopathy. Methods: 42 patients complaining from cervical radiculopathy with age from 30 to 45years were randomly assigned to three equal groups. Group (A) received neural mobilization for median and radial nerve in addition to conventional treatment group (B) received sustained natural apophyseal glide (SNAG) in addition to the conventional treatment group (C) received a conventional physiotherapy program (Hot pack, stretching and strengthening exercises for cervical muscles) for 12 sessions during 4 weeks, 3 sessions /week. All patients were evaluated with the Visual analogue scale, Arabic version of the neck disability index and cervical range of motion device. Results: All groups had statistically significant improvements in all outcome measures post treatment. No significant differences were recorded among the three groups in the pain post treatment. Group A and B similarly improved and higher than group C in respect to neck functional performance. Group B showed significant improvement in cervical range of motion post treatment more than group A and C. Conclusion: Adding sustained natural apophyseal glide or neural mobilization to traditional physiotherapy program is beneficial in management of individuals with chronic unilateral discogenic cervical radiculopathy.