Hypoalgesic Effect of Neural Mobilization Versus Ibuprofen Pharmacologic Treatment
Condition: Cervicobrachial Neuralgia
MeSH terms: Neuralgia; Brachial Plexus Neuritis
Study type: Interventional
Phase: Phase 2/Phase 3

Summary: 
      The purpose of this study is to compare the effectivity of Median Nerve Neural Mobilization
      and oral Ibuprofen in treating patients who suffer cervicobrachial pain
    

Detailed description: 
      Median Nerve Neural Mobilization and Ibuprofen both relieve cervicobrachial pain, but this
      happens through different mechanisms and with a different onset of side effects. Median Nerve
      Neural Mobilization is a physical therapy technique that achieves pain relief through
      mechanical stimulation of the median nerve and the brachial plexus. The proper mechanical
      stimulation of the nerve and its surrounding neural tissue induces a wide variety of
      physiologic responses that may reduce cervicobrachial pain including the activation of
      descending nervous system pain modulation mechanisms, all though the entire set of underlying
      reasons for this pain reduction is not completely understood. Among the effects caused by the
      Neural Tissue Mobilization that produce pain relief are: intraneural edema reduction, changes
      on the intraneural nerve pressure,dispersion of pro-inflammatory substances and an increase
      in nerve mobility

      Ibuprofen is a nonsteroidal anti-inflammatory drug used worldwide to control pain, fever and
      inflammation.Oral intake of Ibuprofen produces a hypoalgesic effect due to biochemical
      inhibition of the COX enzymes, which convert arachidonic acid to prostaglandin H2 (PGH2).
      PGH2, which in turn, is converted by other enzymes to several types of prostaglandins and
      thromboxanes (which are mediators of pain and inflammation).

      Side effects derived from the oral intake of Ibuprofen are related to its systemic action and
      can be severe in some patients. This fact suggests that oral Ibuprofen may not be suitable to
      use in all types of patients suffering from cervicobrachial pain, meanwhile the Median Nerve
      Neural Mobilization has little to no side effects known. This reveals a point of interest in
      determining comparative effectiveness between this two therapeutic options in the treatment
      of cervicobrachial pain.
    

Intervention name(s): Median Nerve Neural Mobilization; Ibuprofen
Intervention type(s): Procedure; Drug
Intervention description(s): Non-surgical non-invasive Median Nerve neural mobilization procedure was applied by a physical therapist continuously during 2 minutes in 5 different occasions with 1 minute of rest between each 2 minute application of the Neural Mobilization technique. The intervention was applied during a period of 6 weeks. The maximum level of elbow extension movement degree without the reproduction of symptoms during the application of the Median Nerve Neural mobilization treatment was determined through the baseline use of a Universal Goniometer Device.; The active comparator group received an oral Ibuprofen treatment. The starting dose was of 400 mg/day and it was increased to a maximum of 1200 mg/day divided in 3 oral intakes every 8 hours depending on patient tolerance.The intervention was applied during a period of 6 weeks.
Other intervention name(s): Neural Tissue Mobilization of the Median Nerve; Median Nerve Neurodynamics; Addaprin®; Advil®; Caldolor®; Cedaprin®; I-Prin®; Midol®; Motrin®; Motrin® IB; NeoProfen®; Profen IB®; Proprinal®; Ultraprin®
Intervention MeSH terms: Ibuprofen
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment