Comparative effects of neural mobilization,mulligan,and maitland mobilization techniques in patients with tennis elbow: A randomized clinical trial

Abstract

Background

Tennis elbow is a common musculoskeletal condition that causes discomfort and functional limitations in the wrist extensors. Manual therapy techniques including neural mobilization, Mulligan, and Maitland mobilization are commonly used to relieve pain and improve upper limb function, but their relative usefulness is unknown.

Objective

To compare between three manual therapy approaches (radial nerve mobilization, Mulligan and Maitland mobilization) to find their effectiveness when they were added to eccentric exercises in patients with tennis elbow. Study Design: Single-blinded, randomized, controlled trial.

Methods

Forty-five tennis elbow participants were randomly allocated into three groups (n = 15 each): Group A received radial nerve neural mobilization, Group B received Mulligan mobilization (MWM), and Group C received Maitland mobilization. Interventions were implemented over six weeks. Pain intensity, Pressure Pain Threshold (PPT), functional disability, and hand grip strength were measured before and after intervention.

Results

Between-group comparison showed no statistically significant differences in post-treatment scores for Pain intensity (p = 0.10), PPT (p = 0.45), functional disability (p = 0.16), and grip strength (p = 0.75). However, the radial nerve neural mobilization group had a greater mean reduction in pain intensity (Pre- post: 4.6–1.8) and improved grip strength (Pre-post:26.65–31.14 kg) compared to the other groups; this difference is numerically greater but statistically insignificant.

Conclusions

Maitland, Mulligan, and neural mobilization approaches are effective in reducing pain and enhancing upper limb function in patients with tennis elbow. Neural mobilization may provide numerically greater therapeutic benefits, but further research with larger sample size and long-term follow-up is needed.