Treatment of Sciatica by Neural Flossing Technique (NFT) in Adults
Keywords:
Neural flossing, nerve, sciatica, rehabilitationAbstract
BACKGROUND:
Sciatica is regarded as the most common and disabling disorder with a prevalence rate of 40% among varying inhabitants which results in an increased rate of pain and decreased or absent sensation in affected dermatomal segments due to compression of the sciatic nerve at the level of L4-S2 segmental level. Many conventional and conservative physical therapy treatment approaches have been used for its management but the effect of Neural Flossing Technique is efficient and cost-effective.
METHODS: Google Scholar, Medline (PubMed) were used for randomized trials to determine the efficacy of neural flossing in sciatica in adults was searched. The search terms were neural flossing, sciatica, treatment, adults, in different combinations. All randomized control trials were conducted with continual outcomes as end-point scores (i.e., mean and standard deviation of the variables with their follow-up and their comparison with baseline values). Ninety-five percent confidence intervals have been conducted/imposed for all outcomes. All Statistical tests were analysed at the significance level of p<0.001.
RESULT: A total of five RCTs was included in this review that met the inclusion criteria. The analysed results showed NFT along with conventional physiotherapy to be effective on both reducing pains [95% CI p<0.001] and disability [95% CI p<0.001] and improving hip range of motion [95% CI p<0.001]. The mean quality methodological score was 3.4 out of 5.
CONCLUSION: Nerve flossing technique was a significantly effective treatment regime for the management of sciatica, reducing pain along with disability, and improved better outcomes in terms of the range of motion at hip joints. The neural flossing technique combined with conventional physical therapy regimes was also effective/produced positive results.
References
Anikwe EE, Tella BA, Aiyegbusi AI, Chukwu SC. Influence of Nerve Flossing Technique on acute sciatica and hip range of motion. Int J Biomed Res. 2015;4(2):91-9.
Basson A, Olivier B, Ellis R, Coppieters M, Stewart A, Mudzi W. The effectiveness of neural mobilizations in the treatment of musculoskeletal conditions: a systematic review protocol. JBI Database Syst Rev Implement Rep. 2015;13(1):65-75.
Chaurasia BD. Hum Anat. 6th ed. 2013; 2:72, 84, 87.
Davis D, Vasudevan A. Sciatica. In: Treasure Island, (FL): Stat Pearls Publishing. p. 2019 Jan-; Updated 2019 Nov 15. Stat pearls
Darshana D. Chaudhary, Neha Ingale, Kalyani Nagulkar. Comparison of nerve flossing and conventional therapy with only conventional therapy for sciatica. Int J of Allied Med Sci and Clin Res 2018; 6(2): 269-276.
Delitto A, George SZ, VanDillen L, Whitman JM, Sowa G, Shekelle P, Denninger TR, Godges JJ, Orthopaedic Section of the American Physical Therapy Association. Low back pain. J Orthop Sports Phys Ther. 2012;42(4): A1-57.
Ellis Richard F, Hing Wayne A. Neural mobilization: A systematic review of randomized controlled trials with an analysis of therapeutic efficacy. J Man Manip Ther. 2008;16(1):8-22.
Hider SL, Konstantinou K, Hay EM, Glossop J, Mattey DL. Inflammatory biomarkers do not distinguish between patients with sciatica and referred leg pain within a primary care population: results from a nested study within the ATLAS cohort. BMC Musculoskeletal Disorder. 2019;20(1).
Health line. 2020. Nerve flossing: how it works for sciatica and other conditions.
Koes BW, van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ. 2007;334(7607):1313-7.
Kranthi P. Efficacy of nerve flossing technique on improving sciatic nerve function in patients with sciatica – A randomized controlled trial. Rom J Phys Ther. 2012;18(30).
Manish Kumar, Garg Gaurav Singh LR, Talever Singh, Tyagi LK. Epidemiology, pathophysiology and symptomatic treatment of sciatica: a review. Int J Pharm Biol Arch. Aug 2011;1050-1061:2011; 2(4).
Mostofi K, Peyravi M, Moghaddam BG. A comparison of sciatica in young subjects and elderly person. J Clin Orthop Trauma. 2020;11(5):889-90.
Mitra M, Gaikwad N. The effect of straight leg raises with lumbar stabilization exercises in subjects of low back pain with adverse neural tension between the age group 20-50 years. Indian J Physiotherapy Occup Ther Int J. 2019;13(1): 101.
Publishing, H. 2019. Sciatica: of all the nerve - Harvard Health.
Ropper AH, Zafonte RD. Sciatica. N Engl J Med. 2015;372(13):1240-8.
Satishkumar BS, Dibyendunarayan BD, Ramalingam TA. Effectiveness of nerve flossing technique in chronic lumbar radiculopathy. Indian J Physiotherapy Occupational Ther Int J. 2017;11(1):44.
Shacklock M. Neurodynamic. Physiotherapy. 1995;81(1):9-16.
Shacklock M. Clinical neurodynamic: A new system of neuromusculoskeletal treatment. UK: Butterworth-Heinemann; 2005.
Vartak HS, Rajapurkar R, Palekar T, Saini S, Khisty A. A comparative study between neural mobilisation techniques versus nerve flossing technique in patients with acute sciatica.2019.
Vroomen PCAJ, de Krom MCTFM, Slofstra PD, Knottnerus JA. Conservative treatment of sciatica: a systematic review. J Spinal Disorder. 2000;13(6):463-9
Valat JP, Genevay S, Marty M, Rozenberg S, Koes B. Sciatica. Best Pract Res Clin Rheumatol. 2010;24(2):241-52
Zhang X, Wang Y, Wang Z, Wang C, Ding W, Liu Z. A Randomized Clinical Trial Comparing the Effectiveness of electroacupuncture versus Medium-Frequency Electrotherapy for discogenic Sciatica. Evid Based Complement Alternat Med. 2017.
Sharma S, Balthillaya G, Rao R, Mani R. Short term effectiveness of neural sliders and neural tensioners as an adjunct to static stretching of hamstrings on knee extension angle in healthy individuals: a randomized controlled trial. Phys Ther Sport 2016; 17:30-7.
Hamed S, Zoheiry I, Waked N. Clinical Trial on Femoral Neuropathy in Haemophilic Patients: Neurodynamic Nerve flossing, conventional selected exercise program - Clinical Trials Registry - ICH GCP.
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