Effectiveness of SNAGs and prescribed strengthening exercise in reduction of cervical facet pain: a case report

ABSTRACT

The objective of the study was to explore the effects of SNAG technique [Sustained Natural Apophyseal Glide] and strengthening of the deep neck muscles in patients with cervical spine facet pain. Recent evidence suggests that deficits in muscle performance of the deep neck flexor muscles play a pivotal role in cervical spine pain. A few reports in the literature states that manual therapy techniques aimed at the cervical spine used in conjunction with exercise produce superior benefits in patients with cervical pain pathology. The evidence in this area is limited and further research is warranted to determine its effect on cervical pain. A 45 year-old female was referred to physical therapy after a nine month history of neck and shoulder pain. Interventions were aimed at reducing the pain, improving the range of motion, and strengthening neck musculature. SNAG to the cervical facets joint were performed in conjunction with deep cervical muscle strengthening exercise interventions. Outcomes included changes in the VAS [visual analog pain scale], the patient rating of overall improvement. At the time of discharge, the patient had a successful outcome based on decreased pain to 2/10 on the VAS [Visual Analog scale] and increase in the strength of deep flexors. This case report indicates SNAG directed to the cervical facets joint and strengthening of deep neck muscles are useful in treatment of cervical spine facet syndrome. A detailed study has to be done to generalize its effect