SNAG versus sciatic nerve mobilization for non-specific sciatica

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

This study will try whether a hands-on SNAG spinal glide or home-based sciatic nerve mobilization exercises work better to reduce pain and improve function in adults aged 20–50 with chronic non-specific sciatica.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 30 (estimated)
• Ages: 20 Years to 50 Years
• Sex: All
• Sponsor: Istinye University (Academic / other)
• Locations: 1 site (Istanbul)
• Trial ID: NCT07161323 on ClinicalTrials.gov

What this trial studies

This is a randomized crossover trial where eligible participants receive one of two interventions—Sustained Natural Apophyseal Glides (SNAGs) delivered by a therapist or guided Sciatic Nerve Mobilization Exercises (SNME)—with pre- and post-treatment assessments. Participants are randomly assigned to one intervention, evaluated immediately after treatment, and then return about ten days later to receive the alternate intervention followed by repeat evaluations. Outcomes include pain measured by the Visual Analogue Scale and function measured by the Oswestry Disability Questionnaire, along with baseline demographic data. The design allows within-person comparison of the two commonly used non-pharmacological approaches for chronic non-specific sciatic pain.

Who should consider this trial

Good fit: Ideal candidates are adults 20–50 years old with unilateral chronic (>12 weeks) non-specific sciatica who have positive Slump and Straight Leg Raise tests and have not received physical therapy in the past month.

Not a fit: Patients with physician-diagnosed herniated disc or spinal stenosis, significant neurological deficits, prior spinal surgery, serious medical conditions, recent pregnancy, or use of medications that alter pain perception are excluded and unlikely to benefit from this comparison.

Why it matters

Potential benefit: If successful, the trial could help clinicians choose a safer non-drug technique that lowers pain and improves daily function for people with chronic non-specific sciatica.

How similar studies have performed: Both Mulligan SNAG techniques and neural mobilization exercises have some supportive evidence for reducing back and leg pain, but direct head-to-head comparisons in chronic non-specific sciatica are limited.

Eligibility criteria

Inclusion Criteria:

* 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.

  b: Exclusion Criteria:
* 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.

Where this trial is running

Istanbul

• Clam Fizyoterapi Merkezi — Istanbul, Turkey (Türkiye) (Recruiting)

Study contacts

• Principal investigator: Çiçek Günday, Asst.Prof. — Istinye University
• Study coordinator: Sohiab Hassan Mohamed Wagdy Ahmed Elsayed Eladawi, Physiotherapist

Conditions Sciatica Pain; Sciatica Acute; Mulligan Mobilization; Sciatic Nerve Pain; Mulligan Concept; Manual Therapy; Pain Management; Non-Specific Sciatica