Study Design: Randomized clinical trial. Objectives: To investigate the immediate and short term treatment effects of soft tissue mobilization versus therapeutic ultrasound in subjects with neck and arm pain who demonstrate signs of neural mechanical sensitivity. Background: Neck and arm pain may be associated with several factors, including neural tissue mechanical sensitivity and soft tissue dysfunction. While experts have suggested that individuals with neck and arm pain and neural mechanical sensitivity may benefit from soft tissue mobilization, there has been little research to investigate this hypothesis. Methods: Twenty subjects with neck and arm pain and a positive supper limb neurodynamic test with median nerve bias (ULNT) were randomly assigned to 1 of 2 treatments provided during a single session: soft tissue mobilization or therapeutic ultrasound. Outcome measures were collected immediately before and after treatment, and at a 2-4 day follow up. Primary outcomes were the Global Rating of Change, range of motion during the ULNT, and pain rating during the ULNT. Secondary measures included the Neck Disability Index, Patient-Specific Functional Scale, Numeric Pain Rating Scale, Body Pain Diagram, active range of should abduction motion, and shoulder abduction combined with wrist extension active range of motion. Results: A greater proportion of subjects in the soft tissue mobilization group reported a significant improvement on the Global Rating of Change Scale, and demonstrated a statistically significant change of 7.5 degrees of the ULNT at immediate follow up, but not at 2-4 day follow up. Subjects who received soft tissue mobilization demonstrated greater improvements in range of motion during ULNT, Patient-Specific Functional Scale, and shoulder combined with wrist extension active range of motion. Both groups reported improvements in Numeric Pain Rating Scale, but there was no significant difference in pain ratings between groups. There were no significant changes in pain rating during the ULNT in either group. Conclusion: Subjects with neck and arm pain demonstrated greater improvements in ULNT range of motion, Global Rating of Change, and Patient-Specific Functional Scale following soft tissue mobilization than after receiving therapeutic ultrasound. Clinicians should consider utilizing soft tissue mobilization in the management of individuals with neck and arm pain. Future research should investigate the use of soft tissue mobilization within multimodal management for neck and arm pain with evidence of neural mechanical sensitivity.
