Shear Wave Elastographic Investigation of the Immediate Effects of Slump Neurodynamics in People With Sciatica

Abstract

Objectives Neurodynamic techniques are often used to treat people with sciatica pain, but their mechanical effects on the sciatic nerve are unknown. Shear wave elastography (SWE) has been shown to effectively estimate the stiffness of peripheral nerves in real time. The aim of this study was to use SWE to assess the effects of slump neurodynamics in the sciatic stiffness of people with sciatica. Methods Sixteen participants volunteered for this study. The sciatic stiffness of 8 patients with unilateral chronic sciatica and 8 healthy control participants was measured by SWE, with the participants in a prone position and during a dynamic condition (ie, ankle dorsiflexion). These measurements were performed before and immediately after the neurodynamic intervention, which consisted of a static slump position applied to the symptomatic limb of the patients with sciatica and in a randomly chosen limb of the healthy participants. Results The 8 patients with sciatica included 6 male and 2 female patients, and the 8 healthy control participants included 5 male and 3 female volunteers. Slump neurodynamics resulted in an immediate decrease in the sciatic nerve stiffness of the symptomatic limb in people with sciatica by 16.1% (effect size = 0.65; P = .019). The intervention showed no significant changes in the sciatic nerve stiffness of the healthy participants (effect size = 0.05; P = .754). Conclusions Slump neurodynamics have the potential of decreasing the sciatic nerve stiffness in people with sciatica, and this effect can be quantified by SWE, which may provide valuable information for health professionals.

Spatial variation in mechanical properties along the sciatic and tibial nerves: An ultrasound shear wave elastography study

“…Several studies have investigated the shear wave velocity of the sciatic nerve including the response to passive joint motion and various limb postures (Andrade et al, 2016;Greening and Dilley, 2017), adaptations to acute and chronic tensile loads in either healthy (Andrade et al, 2018;Andrade et al, 2020) or impaired (Neto et al, 2020) nerves. These studies have typically examined the shear wave velocity at one single location along the course of sciatic and tibial nerves.…”

Neurodynamics: is tension contentious?

“…There is a growing body of evidence of in-vivo studies supporting that mechanical properties of human peripheral nerves are altered in various peripheral neuropathies, such as those associated with nerve compression [60], metabolic syndrome [61], and radiculopathies [62][63][64]. Interestingly, a preliminary study reported that a 3-min slump (static) stretch resulted in an immediate decrease in sciatic nerve stiffness in people with unilateral sciatica [65].…”

Neuropathic Pain and Ultrasonography: A Multiperspective Literature Evaluation

“…US showed a high level of success to guide the nerve block and, in Morton’s neuroma, US seemed to reduce the risks and increase the effectiveness of the treatment [ 26 ]. Concerning other diseases, the diagnostic contribution of US was even assessed in sciatica, where it showed morphological changes of the nerve, with enlargement and higher stiffness in the impaired nerve [ 27 , 28 ]. In the cases of herpes/postherpetic neuralgia, US was mainly used to guide the treatment, improving painful symptoms [ 29 ].…”