Low back pain (LBP) is one of the most prevalent and costly musculoskeletal disorders, affecting up to 80% of adults at some point in their lives. Neural mobilization (NM) is a therapeutic technique used in the treatment of LBP, which aims to improve neural tissue mobility and reduce pain. However, there is no validated sham NM intervention for lower quadrant conditions, which limits the ability to blind patients with LBP and may introduce bias due to the confounding effects of expectations. Therefore, González et al. (2021) conducted a research study to develop a sham NM technique in patients with non-specific LBP and assess its validity in supplying a suitable blinding. Additionally, the study compared the short-term effects of NM and the sham comparator on pain and the straight leg raise.

A randomized placebo-controlled trial was conducted, in which 51 patients with non-specific LBP were randomly allocated to an NM group or a sham NM group. The primary outcome was the believability of the sham technique, which was measured one week after the intervention. Secondary outcomes were pain intensity and the straight leg raise range-of-motion, which were assessed at baseline, immediately after the intervention, and one week after. Both participants and assessors were blinded to the group allocation.

The believability of the sham technique in terms of the frequencies of perceived group assignment showed no differences between groups. Eighteen participants believed they had received the experimental NM technique in the experimental group (69.2%) and 14 in the placebo NM group (56%). Pain and the straight leg raise changes did not show differences between groups.

The results of this study suggest that the novel sham NM technique is a believable intervention, capable of supplying a suitable blinding. Both groups showed similar short-term perceived effects on pain and the straight leg raise. These findings are important because they suggest that the use of a sham NM technique as a comparator in future trials may help to reduce bias and improve the validity of study results.

In conclusion, the development of a sham NM technique in patients with non-specific LBP has been successfully achieved. The technique was demonstrated to be a believable intervention, capable of supplying a suitable blinding. The results of this study suggest that the use of a sham NM technique as a comparator in future trials may help to reduce bias and improve the validity of study results. Further research is needed to investigate the long-term effects of NM and the sham comparator on pain and function in patients with LBP.

Reference: González ÁC, Berenguer SB, Luque Mañas JM, Martin-Pintado-Zugasti A. Validation of a sham novel neural mobilization technique in patients with non-specific low back pain: A randomized, placebo-controlled trial. Musculoskelet Sci Pract. 2021 Jun;53:102378. doi: 10.1016/j.msksp.2021.102378. Epub 2021 Apr 15. PMID: 33930856.