Effect of median nerve neural mobilisation and cervical lateral glide on pain, disability and function in nerve-related neck and arm pain: a systematic review and meta-analysis

Key points

1. 01Both are neurodynamic treatments: cervical lateral glide moves the neck to ease tension on the nerve, while median nerve neural mobilisation glides the nerve itself within the surrounding tissue.
2. 02Cervical lateral glide reduced pain versus no treatment by about 2.5 points and versus other physical therapy by about 1.3 points.
3. 03Median nerve neural mobilisation reduced pain versus no treatment by about 3 points.
4. 04Effects on disability were modest and varied widely across studies (standardised mean difference -0.50 to -1.22), with substantial heterogeneity.
5. 05The authors graded certainty as low to very low and suggest the techniques work best when there is a clear nerve-sensitivity or neuropathic component to target.

How it was conducted

Design

Systematic review and meta-analysis of randomised controlled trials (PRISMA 2020, RoB2, random-effects models; PROSPERO CRD42020216739)

Search

MEDLINE, ScienceDirect, Cochrane Library, PEDro, and Google Scholar searched to 30 June 2025

Included studies

20 randomised controlled trials with 953 patients with nerve-related neck and arm pain

Interventions

Cervical lateral glide and median nerve neural mobilisation, compared with no treatment or with other physical therapy

Outcomes

Pain, disability, and function; pain pooled as a mean difference and disability as a standardised mean difference

What they found

• Cervical lateral glide versus no treatment: pain mean difference -2.47 (95% CI -3.41 to -1.53, P < .001; 3 studies).
• Cervical lateral glide versus other physical therapy: pain mean difference -1.29 (95% CI -2.54 to -0.05, P = .04; 2 studies).
• Median nerve neural mobilisation versus no treatment: pain mean difference -3.07 (95% CI -3.78 to -2.37, P < .001; 4 studies).
• Disability: modest effects across 12 studies, standardised mean difference ranging -0.50 to -1.22, with moderate to high heterogeneity.
• GRADE certainty of evidence was low to very low.

Limitations

• Certainty of evidence was low to very low, driven by risk of bias and inconsistency across trials.
• Moderate to high heterogeneity means the pooled effect sizes, especially for disability, are imprecise.
• Each pain comparison rested on a small number of trials (2 to 4 studies).
• Pain was measured on mixed scales, so the exact clinical size of the benefit is hard to interpret.

Why it matters

For patients

Gentle nerve-gliding and neck movement techniques can help reduce nerve-related neck and arm pain, usually alongside other treatment rather than on their own.

For clinicians

Consider cervical lateral glide and median nerve neural mobilisation within multimodal care for nerve-related neck and arm pain, while recognising the evidence is low certainty and best targeted at patients with a clear neural sensitivity component.

For readers

A consistent direction of benefit across 20 trials is encouraging, but low certainty and wide heterogeneity mean the true effect size is still unsettled.