Cervical SNAGs for Neck Pain
- Posted on: Sep 23 2022
Low back and neck pain has become more prevalent in the last decade. According to National Interview Health survey data of 2019, 39.0% of adults had back pain, 36.5% had lower limb pain, and 30.7% had upper limb pain. Having to deal with low back and/or neck pain during activities of daily life becomes frustrating and challenging for patients.
A sustained natural apophyseal glide (SNAG) is a mobilisation technique and is used as a part of Mulligan concept. SNAGs are commonly used in the treatment of painful movement restrictions of the cervical spine. SNAGs are gliding techniques and need to be performed pain-free till the end range of movement, meaning while performing the technique the patient should not feel any pain. The therapist applies the glide to the joint and maintains it while the patient performs the movement that is restricted and painful. Mulligan proposed that when an increase in pain-free range of movement occurs with a SNAG it is primarily the correction of a positional fault at the zygapophyseal joint, although a SNAG also influences the entire spinal functional unit (Tank et al., 2018) . Research shows that cervical sustained natural apophyseal glides are effective in improving cervical ROM, reducing pain and maintaining effects for about 12 weeks.
While SNAGs are performed by physical therapists in the clinic setting, home exercises to maintain its effects need to be performed by patients on a regular basis for effective outcomes.
Below is an example that can be performed by patients who have responded well to SNAGs in the clinic setting. Patients would need a towel to perform this exercise.Therapists should ask patient’s to perform the correct technique in the clinic before giving it as a home exercise.
Cervical SNAGs for rotation
Above exercise depicts self SNAGs for pain during right rotation movement. It is important to remember to hold the glide till the entire movement is completed. It can be performed in 3 sets of 10 repetitions 2-3 times a day.
Tank, K. D., Choks, P., & Makwana, P. (2018). To study the effect of Muscle Energy Technique versus Mulligan snags on pain, range of motion and functional disability for individuals with mechanical neck pain”. – A comparative study. International Journal of Physiotherapy and Research, 6(1), 2582–2587. https://doi.org/10.16965/ijpr.2017.253
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