Effect of Femoral Nerve Neurodynamic Techniques on Pain in Patellofemoral Pain Syndrome: A Randomised Controlled Trial

Abstract

Design

A randomised controlled trial was designed to evaluate the added value of femoral nerve neurodynamic techniques on knee pain and function in patients with patellofemoral pain syndrome.

Setting: University Physiotherapy Clinic.

Participants: 71 patients with unilateral patellofemoral pain syndrome aged 18–45 years were randomised.

Intervention: Patients were assigned to either the treatment group, receiving femoral nerve neurodynamic techniques and standard physiotherapy, or the control group, receiving standard physiotherapy alone, for 10 sessions.

Main measures: Outcome measures include visual analogue scales at rest and during activity, functional ability measured with the Kujala patellofemoral score, and the range of hip extension recorded at baseline and immediately post-intervention.

Results

After 10 sessions, the combined effect of femoral nerve neurodynamic techniques and standard physiotherapy showed significantly greater improvements in pain scores compared with the standard physiotherapy alone: pain at squat (adjusted mean difference: −6.12, 95% CI: −10.37, −1.87), pain at stair (adjusted mean difference: −7.76, 95% CI: −12.01, −3.53), pain at kneel (adjusted mean difference: −6.57, 95% CI: −9.97, −3.17), and pain at sitting (adjusted mean difference: −5.31, 95% CI: −8.88, −1.74). Additional benefits were observed in knee function (adjusted mean difference: 7.06, 95% CI: 4.56, 9.55) and hip extension (adjusted mean difference: 2.09, 95% CI: 1.27, 2.90).

Conclusions

The combination of femoral nerve neurodynamic techniques with standard physiotherapy demonstrated promising short-term reductions in knee pain and improvements in function among patients with patellofemoral pain syndrome. These findings suggest that femoral nerve neurodynamic techniques may offer additional benefits as an adjunct therapy, although further research with longer follow-up is needed to confirm the durability of these effects.