The effectiveness of neural mobilization in addition to conservative physiotherapy on cervical posture, pain and functionality in patients with cervical disc herniation

Introduction
Medical treatment, conservative physiotherapy (CP), exercise, mobilization and prevention methods should be taken into consideration in cervical problems. We aimed to investigate the efficacy of neural mobilization (NM) combined with CP on cervical posture, pain functionality in patients with cervical disc herniation (CDH).

Material and methods
Sixty patients with CDH and radicular pain participated in this randomized controlled study. They were randomly allocated into two groups. The control group (n=30) received CP (hotpack, transcutaneous electrical nerve stimulation, ultrasound), and the experimental group (n=30) received CP plus NM on the radial, median and ulnar nerves. Both groups received the CP for three weeks (15 sessions). The experimental group received the neural mobilization technique for three weeks (3 sessions per week). The demographic data, severity of pain (by Visual Analog Scale), cervical active range of motion degree, and cervical posture data (by Tragus to Wall test, Measurement of C7 to Wall Distance) have been recorded. Neck Disability Index (NDI) was applied to all participants for functionality.

Results
The distance between tragus and the wall decreased in the experimental group (p<0.05), whereas there was not any significant difference in the distance between C7 and the wall (p>0.05). The scores of pain and cervical active range of motion were found different in favor of the experimental group (p<0.05). The NDI scores were similar in both groups (p>0.05).

Conclusions
CP together with NM techniques will provide additional gains in cervical posture, pain, and active range of motion in patients diagnosed with cervical disc herniation.