Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun;14(4):871-879.
doi: 10.5114/aoms.2017.70328. Epub 2017 Sep 26.

Effectiveness of median nerve neural mobilization versus oral ibuprofen treatment in subjects who suffer from cervicobrachial pain: a randomized clinical trial

David Rodriguez Sanz  1 , Francisco Unda Solano  2 , Daniel López López  3 , Irene Sanz Corbalan  4 , Carlos Romero Morales  1 , Cesar Calvo Lobo  5
Affiliations

Effectiveness of median nerve neural mobilization versus oral ibuprofen treatment in subjects who suffer from cervicobrachial pain: a randomized clinical trial

David Rodriguez Sanz et al. Arch Med Sci. 2018 Jun.

Abstract

Introduction: Oral ibuprofen (OI) and median nerve neural mobilization (MNNM) are first line treatments for patients who suffer cervicobrachial pain (CP). OI may produce side effects which are not tolerated by all subjects who suffer CP, whereas MNNM has no known side effects. Therefore, the aim of this study was to assess the effectiveness of both treatments (OI vs. MNNM) in CP.

Material and methods: This investigation was a blinded parallel randomized clinical trial (NCT02593721). Sixty-two participants diagnosed with CP were recruited and randomly assigned to 2 groups (n = 31), which received MNNM or 1200 mg/day OI treatment for 6 weeks. The numeric rating scale for pain intensity was the primary outcome. The cervical rotation range of motion (CROM) and the upper limb function were the secondary outcomes.

Results: The results showed that OI treatment (η2 = 0.612-0.755) was clearly superior to MNNM (η2 = 0.816-0.821) in all assessments (p < 0.05) except for the CROM device results, which were equivalent to those of the MNNM group (p > 0.05). Three subjects were discharged because of OI side effects.

Conclusions: Oral ibuprofen may be superior to MNNM for pain reduction and upper limb function increase of subjects with CP. Nevertheless, both treatments were effective. Median nerve neural mobilization may be considered an effective non-pharmaceutical treatment option in subjects with CP. Regarding OI adverse effects, our findings challenge the role of pharmacologic versus manual therapy as possible treatments that may improve pain intensity and upper limb functionality in subjects with CP.

Keywords: musculoskeletal manipulations; non-steroidal anti-inflammatory agents; rehabilitation; upper extremity.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Participant flow diagram of voluntary participants through different study phases n – number of subjects, MNNM – median nerve neural mobilization, OI – oral ibuprofen.
See this image and copyright information in PMC

References

    1. Huisstede BM, Bierma-Zeinstra SM, Koes BW, Verhaar JA. Incidence and prevalence of upper-extremity musculoskeletal disorders. A systematic appraisal of the literature. BMC Musculoskel Disord. 2006;7:7. - PMC - PubMed
    1. Radhakrishnan K, Litchy WJ, O’Fallon WM, Kurland LT. Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990. Brain. 1994;117:325–35. - PubMed
    1. Daffner SD, Hilibrand AS, Hanscom BS, Brislin BT, Vaccaro AR, Albert TJ. Impact of neck and arm pain on overall health status. Spine (Phila Pa 1976) 2003;28:2030–5. - PubMed
    1. Cowell IM, Phillips DR. Effectiveness of manipulative physiotherapy for the treatment of a neurogenic cervicobrachial pain syndrome: a single case study – experimental design. Manip Ther. 2002;7:31–8. - PubMed
    1. Salt E, Wright C, Kelly S, Dean A. A systematic literature review on the effectiveness of non-invasive therapy for cervicobrachial pain. Manip Ther. 2011;16:53–65. - PubMed