Comparative Effects of Nerve Flossing and Cox Technique in Sciatica
DOI:
https://doi.org/10.61919/jhrr.v3i2.332Keywords:
Sciatica, Nerve Flossing Technique, Cox Technique, Pain, Functional Disability, PhysiotherapyAbstract
Background: Sciatica is a prevalent condition characterized by pain that radiates along the path of the sciatic nerve, affecting a significant portion of the adult population at some point in their lives. Traditional treatment modalities have varied in effectiveness, prompting the exploration of alternative therapies such as Nerve Flossing Technique (NFT) and Cox Technique (CT). This study aims to compare the efficacy of these two non-invasive treatments in alleviating the symptoms of sciatica.
Objective: The primary objective of this study was to evaluate and compare the effects of Nerve Flossing Technique and Cox Technique on reducing pain and improving functional disability in patients with sciatica.
Methods: This randomized controlled trial was conducted at the outpatient department of physiotherapy in Allied Hospital and District Head Quarter Hospital, Faisalabad. Forty-two patients with sciatica were randomly assigned to either Group A (NFT group) or Group B (CT group) and received the interventions for six weeks, with four sessions per week. Each session included a conventional treatment of hot pack application, TENS, and stretching exercises for 15 minutes, followed by the respective group's technique. Pain intensity was measured using the Numeric Pain Rating Scale (NPRS), and functional disability was assessed with the Modified Oswestry Disability Index (MODI) before and after the intervention period.
Results: Both groups showed significant improvements in pain and functional disability post-treatment. Group A (NFT) exhibited a reduction in NPRS scores from a median of 7 to 2 and an improvement in MODI scores from 52.167±5.13 to 22.77±4.30, indicating a mean difference of 29.38±4.57 (p<0.05). Group B (CT) showed a reduction in NPRS scores from a median of 7 to 5 and an improvement in MODI scores from 53.61±5.30 to 41.05±10.26, with a mean difference of 12.55±7.67 (p<0.05). The between-group comparison revealed a more significant improvement in Group A in terms of both NPRS and MODI scores (p<0.05).
Conclusion: The study concluded that both Nerve Flossing Technique and Cox Technique are effective in reducing pain and improving functional disability in patients with sciatica. However, the Nerve Flossing Technique demonstrated a significantly greater improvement compared to the Cox Technique, making it a more favorable non-invasive treatment option for sciatica.
Downloads
References
Williams K, Barraza JM, Cox ER. Effects of Neural Tension on Hamstring Flexibility in Collegiate Dancers: Neural Gliding vs. Dynamic Stretching 2021.
Mennecart T, Normand A, Lermusiaux P, Millon A, Della Schiava N, Tresson P. Anatomical Considerations of Infrageniculate Popliteal Artery Puncture: Alternative Pathway for Retrograde Access After Failed Re-entry. Annals of Vascular Surgery. 2020;67:388-94.
Migliore L, McGee C. Neck and Back Disorders in Esports. Handbook of Esports Medicine: Clinical Aspects of Competitive Video Gaming: Springer; 2021. p. 71-118.
Lebert R. Evidence-Based Massage Therapy: A Guide for Clinical Practice. 2020.
Hatem M, Martin HD. Deep Gluteal Space with Surgical Technique. Hip Arthroscopy and Hip Joint Preservation Surgery: Springer; 2022. p. 1335-72.
Budisulistyo T, Husni A, Tugasworo D, Pudjonarko D. Pain Improvement Among Chronic Lumbar Disc Herniation Patients Underwent Epidural Triamcinolone With Or Without Hyaluronidase Injection Within 3 Months Of Follow-Up: A Prospective Study. Medica Hospitalia: Journal of Clinical Medicine. 2023;10(1):44-51.
Budisulistyo T, Husni A, Pramukarso DT, Pudjonarko D. Effect of caudal epidural adhesiolysis plus steroid injections on pain and daily activities among chronic lumbar disc herniation patients; an observational study. Anaesthesia, Pain & Intensive Care. 2023;27(2):198-203.
Tharani G, Paul J, Alagesan J. Exploring the Effectiveness of Peroneal Nerve Flossing in Alleviating Diabetic Peripheral Neuropathy Symptoms. Journal for ReAttach Therapy and Developmental Diversities. 2023;6(10s):550-8.
Peacock M, Douglas S, Nair P. Neural mobilization in low back and radicular pain: a systematic review. Journal of Manual & Manipulative Therapy. 2023;31(1):4-12.
Alvani E, Golpayegani M, Shahrjerdi S, barkhori Mahny S. The effect of selected corrective exercises on athletes sciatic nerve pain. Anesthesiology and Pain. 2023;13(4):40-7.
Paley CA, Wittkopf PG, Jones G, Johnson MI. Does TENS reduce the intensity of acute and chronic pain? A comprehensive appraisal of the characteristics and outcomes of 169 reviews and 49 meta-analyses. Medicina. 2021;57(10):1060.
Hamed SA, Zoheiry IM, Waked NM, Mahmoud LSE-D. Effect of Neurodynamics Nerve Flossing on Femoral Neuropathy in Haemophilic Patients: A randomized controlled study. Journal of Musculoskeletal & Neuronal Interactions. 2021;21(3):379.
Modarresi S, Lukacs MJ, Ghodrati M, Salim S, MacDermid JC, Walton DM. A systematic review and synthesis of psychometric properties of the numeric pain rating scale and the visual analog scale for use in people with neck pain. The Clinical Journal of Pain. 2022;38(2):132-48.
Cook CE, Garcia AN, Wright A, Shaffrey C, Gottfried O. Measurement properties of the Oswestry Disability Index in recipients of lumbar spine surgery. Spine. 2021;46(2):E118-E25.
Amjad F, Mohseni-Bandpei MA, Gilani SA, Ahmad A, Waqas M, Hanif A. Urdu version of Oswestry disability index; a reliability and validity study. BMC musculoskeletal disorders. 2021;22(1):1-11.
Afzal M, Memon S. Treatment of Sciatica by Neural Flossing Technique (NFT) in Adults. Pakistan Journal of Rehabilitation. 2022;11(1):8-16.
Ghatage T, Jarag R, Jadhav S, Raut R. International Journal of Allied Medical Sciences and Clinical Research (IJAMSCR). Insulin. 2022;1(2).
Kruse RA, White BA, Gudavalli S. Management of Lumbar Radiculopathy Associated With an Extruded L4-L5 Spondylolytic Spondylolisthesis Using Flexion-Distraction Manipulation: A Case Study. Journal of Chiropractic Medicine. 2019;18(4):311-6.
Riaz MU, Shah F, Shah SM. Comparison of Spinal Mobilization with Leg Movement and Neurodynamic Sliding Technique for Improving Function in Radicular Leg Pain: JRCRS. 2020; 8 (1): 33-36. Journal Riphah College of Rehabilitation Sciences. 2020;8(1):33-6.
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. International Journal of Basic and Applied Research. 2019;9(3):909-22.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Shahid Ahmed (Heera), Muhammad Adeel Tahir, Abesha Shahid
This work is licensed under a Creative Commons Attribution 4.0 International License.
Public Licensing Terms
This work is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). Under this license:
- You are free to share (copy and redistribute the material in any medium or format) and adapt (remix, transform, and build upon the material) for any purpose, including commercial use.
- Attribution must be given to the original author(s) and source in a manner that is reasonable and does not imply endorsement.
- No additional restrictions may be applied that conflict with the terms of this license.
For more details, visit: https://creativecommons.org/licenses/by/4.0/.
