The use of neurodynamic mobilization in patients with cervical spondylotic radiculopathy: in mild pain or pain-free range? A randomized controlled trial

Background: Cervical spondylotic radiculopathy is commonly seen nowadays, and neurodynamic mobilization is believed to be effective in treating this condition. However, the ideal degree of neurodynamic mobilization is still unknown. The aim of this study was to investigate the effect of different neurodynamic mobilization intensity in treating cervical spondylotic radiculopathy. Methods: Forty patients with cervical spondylotic radiculopathy were included and randomly allocated into pain-free mobilization group or the mild pain mobilization group. Interventions included conventional rehabilitation therapy plus pain-free or mild pain neurodynamic mobilization, with two sessions/day for five days. The outcome measurements included VAS pain scale, neck range of motion, and Vernon-Mior neck disability index, at baseline before, immediate after treatment, and 1-, 2-, and 4-weeks post treatment as follow-ups. Results: Baseline comparison showed no group differences (P > 0.05). Significant differences were found before the intervention and 4 weeks after the treatment in all outcome measures (p <0.05) in both groups. While there were no significant differences between groups after treatment, the outcome measures in the mild pain group were slightly better than the pain-free group. Conclusions: This was the first study to evaluate neurodynamic mobilization based on pain intensity rather than different ranges of motion. A new classification of neurodynamic mobilization was proposed in this study. Clinicians can use this classification as reference, combining their own clinical reasoning, clinical experiences and patient’s responses to guide the decisions when choosing neurodynamic mobilization technique. Trial registration This study was registered on the Chinese Clinical Trial Registry, with the number of ChiCTR2000031842 on 12/04/2020.