SNAG and SNME in Non-Specific Sciatic Pain
Comparison of the Acute Effects of Sustained Natural Apophyseal Glide and Sciatic Nerve Mobilization Exercises in Non-Specific Sciatic Nerve Pain
Istinye University
30 participants
Jul 1, 2025
INTERVENTIONAL
Conditions
Summary
This study is designed as a crossover trial. All participants who meet the inclusion criteria and voluntarily agree to participate will be evaluated using the assessment methods detailed below. Subsequently, participants will be randomly assigned into two groups. The first group (Mulligan Concept Group - MCG) will receive the SNAG technique, while the second group (Neural Mobilization Group - NMG) will perform the Sciatic Nerve Mobilization Exercise (SNME). After the intervention, participants will be evaluated a second time. Ten days after this session, participants will be invited back. Those who were in the MCG group during the first session will be re-evaluated and then receive the SNGE intervention. Participants who were in the SNGE group during the first session will be re-evaluated and then receive the SNAG intervention. Following this second intervention, participants will be evaluated once again. Assessments will be done are Demographic Form, Visual Analogue Scale, Oswestry Disability Index, Joint Range of Motion, Five-times Sit-to-stand Test, Sit and Reach Test
Eligibility
Inclusion Criteria5
- Adults between the ages of 20 and 50,
- Individuals describing non-specific sciatic pain characterized by unilateral low back pain accompanied by radiating symptoms to the leg,
- Duration of pain longer than 12 weeks,
- Presence of pain during the Slump Test and Straight Leg Raise Test,
- No history of any physical therapy or intervention in the past month.
Exclusion Criteria9
- Individuals diagnosed with herniated disc or spinal stenosis by a physician,
- Physician-diagnosed secondary neurological conditions,
- History of spinal surgery,
- Individuals describing the origin of their pain as the lower back (without leg involvement),
- Presence of neurological symptoms (e.g., foot drop, significant muscle weakness),
- Serious medical conditions that may affect treatment or outcomes (e.g., cancer, infections, or inflammatory diseases),
- Pregnancy or recent childbirth (within the past year),
- Use of medications that may affect pain perception or mobility (e.g., opioids),
- Inability to comply with the weekly treatment schedule.
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Interventions
In this intervention, participants will initially receive the SNAG technique targeting the L5-S1 lumbar segment. Participants will be seated on a treatment table with feet flat and knees at 90°. The therapist will position a specialized Mulligan belt around the L5-S1 segment and anchor it around their pelvis to generate a gentle traction force via controlled hip movement. While this force is applied, participants will perform active trunk flexion, holding the end-range position for 30 seconds. This movement will be repeated six times, constituting a 3-minute set. A total of 4 sets will be administered, with 2-minute rest periods between sets.
Participants will sit with hips and knees at 90° flexion, feet flat on the floor. The involved leg will be fully extended at the knee. In this position, the participant will be asked to perform ankle dorsiflexion and neck extension simultaneously (applying tension to the distal part of the sciatic nerve while relaxing the proximal part) and hold for 3 seconds. Next, the participant will plantarflex the ankle and flex the neck (tensioning the proximal end while relaxing the distal), again holding for 3 seconds. This 6-second sequence will be repeated 10 times per set. The exercise will be performed in 3 sets per leg, with 3-minute rests between sets.
Locations(1)
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NCT07161323