Efficacy of the Mulligan Concept: NAGS, SNAGS, and MWMS for the Spine and Extremities

Abstract

1. Clinical Bottom Line: Overall it appears that there is not enough evidence that suggests that the Mulligan technique is beneficial for patients with decreased ROM and increased pain in the extremities or spinal facet joints. At this point there is still limited research on the long term effects and efficacy of the Mulligan technique for patients with decreased ROM and/or pain. Our research found a limited number of articles providing convincing evidence for the efficacy for the Mulligan technique. Only one of the articles appraised examined the long term effects of the Mulligan Technique at increasing ROM or decreasing pain. 2. Clinical Scenario: A patient with decreased ROM and increased pain in the lumbar spinal facets due to overuse and poor body mechanics has come to our clinic and asked about the effectiveness of manual therapy for decreasing his pain and increasing his ROM. The patient has received conservative physical therapy for his dysfunction with little to no success and has not received manual therapy. The patient’s orthopedic physician has now referred him/her to our clinic in order to restore the patient’s ROM and improve pain tolerance. Over the past few weeks we have observed several other therapists in the clinic using Mulligan’s Concept for low back pain and we are interested in the efficacy of the technique for decreasing pain and improving ROM in the lumbar spine