Comparison of the Acute Effects of Sustained Natural Apophyseal Glide and Sciatic Nerve Mobilization Exercises in Non-Specific Sciatic Nerve Pain

The sciatic nerve, formed by the union of five spinal nerve roots (L4, L5, S1, S2, and S3), is one of the largest and most important peripheral nerves, carrying both motor and sensory fibers. Due to its complex anatomical course and position, sciatic nerve pain is a common form of neuropathic pain. Despite its high prevalence, research on the effectiveness of non-pharmacological treatments remains limited, restricting the development of evidence-based clinical guidelines for primary care management. One such conservative approach is sciatic nerve mobilization, also known as neurodynamic techniques or nerve gliding exercises. Sciatic Nerve Mobilization Exercises (SNME) aim to facilitate gentle sliding of the sciatic nerve along its anatomical pathway without overstretching or irritating it, thereby reducing pain and improving function. On the other hand, the Mulligan Concept (MC) is a modern manual therapy approach incorporating sustained natural apophyseal glides (SNAGs), especially effective for spinal dysfunctions. These mobilizations are typically pain-free and performed in conjunction with active patient movement. SNAGs target the lumbar spine to restore joint mechanics and relieve pain. Widely adopted in clinical practice, this method is used by a significant number of physiotherapists in the UK and US, often as part of their routine patient care. While both SNME and SNAGs are commonly used for managing non-specific sciatic pain, direct comparisons of their clinical efficacy are scarce. Therefore, this study aims to fill that gap by evaluating and comparing the acute effects of these two interventions in individuals with non-specific sciatic nerve pain. The objectives are to determine which technique is more effective in reducing pain, enhancing functional mobility, and improving daily activity performance. The study also seeks to assess which intervention yields better outcomes in terms of range of motion, functional movement, and flexibility. The null hypothesis (H0) posits no significant difference between SNME and SNAGs in improving pain and function in patients with non-specific sciatic pain, whereas the alternative hypothesis (H1) suggests a significant difference between the two. This research holds clinical relevance in guiding physiotherapists toward evidence-based interventions tailored to the needs of individuals suffering from this widespread and disabling condition.