Laurie's Blogs.

Having a pinched nerve sucks!  Pain that the site of the pinch and often pain down the arm or leg.  This blog comes about after reading an abstract of a systematic review about neural mobilizations in low back pain and radicular pain.  Let’s dive in!

So, firstly, what is Radicular Pain?  Simply put, it’s pain that radiates from your spine (typically) into an appendage.  It can be accompanied by numbness, tingling, and muscle weakness. Radicular pain occurs when the spinal nerve gets compressed (pinched) or inflamed.  

What did the Review Paper have to say?

Peacock M, Douglas S, Nair P. Neural mobilization in low back and radicular pain: a systematic review. J Man Manip Ther. 2023 Feb;31(1):4-12. 

Background: Low back pain can present with radicular pain caused by lumbosacral nerve root pathology. Neural mobilization (NM) is a treatment technique used to treat low back and radicular pain (LBRP).

Study selection: Randomized controlled trials assessing the effect of NM on pain, disability, and/or function in adults with LBRP.

Data synthesis: Eight studies were included. Six of the eight studies found the addition of NM to conservative treatment improved all measured outcomes. One study found improvements in some but not all functional measures, and delayed improvements in pain. One study found improvements in measures of neural sensitivity, but not overall pain and disability.

Conclusions: NM may be an effective tool for short-term improvements in pain, function, and disability associated with LBRP. Additional high quality research is needed.

Okay… so it’s a technique that can help a pinched nerve with referred pain.  Great.  What does it look like in dogs?  Check out a series of Videos in Four Leg or the quicky (not very elaborate or detailed) Four Leg Rehab Minute video I just did.  https://youtu.be/qATC1DxeLUo  

AND… What’s in the literature to validate this for canine purposes?

Babbage CS, Coppieters MW, McGowan CM. Strain and excursion of the sciatic nerve in the dog: biomechanical considerations in the development of a clinical test for increased neural mechanosensitivity. Vet J. 2007 Sep;174(2):330-6. 

“It was concluded that, the sciatic nerve in dogs accommodates to joint movements by stretching and gliding. This biomechanical analysis has contributed to the development of a clinical test equivalent to the human straight leg raise to evaluate increased mechanosensitivity of the lumbosacral plexus.”

And I thought there was a second canine neural glide study, but I cannot find it right now, and going down the Pubmed rabbit hole, I can’t find it anywhere.  So I guess I just wrap up this blog!

The take away:

Dural mobilizations (aka: nerve glides, nerve flossing, adverse tissue tensioning techniques) can be used as a complement to other treatments targeting nerve pain.  So, add that to your list of things to learn!

Cheers!  Laurie