Short-term efficacy of neural mobilisation for patients with nerve-related neck and arm pain

Participants assigned to neural mobilisation will receive one-on-one treatments with a physiotherapist (4 treatments over 2 weeks). The physiotherapist will apply 2 manual therapy techniques and prescribe 2 nerve gliding exercises for a home program at each treatment session. The manual therapy techniques include a cervical lateral glide away from the symptomatic arm and a shoulder girdle oscillation technique. Each manual therapy technique will be applied for a total of 4 minutes at each treatment session. The nerve gliding exercises for the home program include a 'sliding' technique and a 'tensioning' technique biased toward the median nerve and cervical nerve roots. In a 'sliding' technique, a movement that lengthens the median nerve bed (e.g., elbow and wrist extension) is counterbalanced by another movement that shortens the nerve bed (e.g., neck side-bending toward the symptomatic arm). A 'tensioning' technique involves simultaneous movements that lengthen the median nerve bed (e.g., elbow and wrist extension combined with neck side-bending away from the symptomatic arm). Participants will perform 10-15 repetitions of the 'sliding' and 'tensioning' techniques 3 times daily on days they do not attend treatment. On days that participants attend treatment, 10-15 repetitions of the 'sliding' and 'tensioning' techniques will be performed under the guidance of the physiotherapist. This will enable the physiotherapist to check that nerve gliding exercises are performed correctly and to progress exercises as necessary. All manual therapy techniques and nerve gliding exercises will not provoke participants' symptoms. The maximum sensory response allowed during each technique is a gentle stretching or pulling sensation that settles immediately upon completion of the technique.