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      Mechanism, application and effect evaluation of nerve mobilization in the treatment of low back pain: A narrative review

      research-article
      Author(s): , MD a , , MD a , , PhD a , * ,
      Publication date (Electronic):
      Journal: Medicine
      Publisher: Lippincott Williams & Wilkins
      Keywords: low back pain, lumbar spine, manual therapy, nerve mobilization, physical therapy

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          Abstract

          Lower back pain is a prevalent condition affecting people across all age groups and causing significant personal and societal burdens. While numerous treatments exist, nerve mobilization has emerged as a promising approach for managing lower back pain. Nerve mobilization involves applying gentle and rhythmic movements to the affected nerves, promoting normal nerve function and releasing tension. It has been well documented that nerve mobilization can be effective in reducing pain and improving function in patients with lower back pain, but the underlying mechanisms have not been clarified. This study aims to review the mechanisms of nerve mobilization in the management of lower back pain, its application, and effectiveness evaluation, and provide a potential solution for managing lower back pain.

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          Anti-inflammatory and immune-regulatory cytokines in rheumatoid arthritis

          Zhu Chen, Aline Bozec, Andreas Ramming … (2018)
          Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by a failure of spontaneous resolution of inflammation. Although the pro-inflammatory cytokines and mediators that trigger RA have been the focus of intense investigations, the regulatory and anti-inflammatory cytokines responsible for the suppression and resolution of disease in a context-dependent manner have been less well characterized. However, knowledge of the pathways that control the suppression and resolution of inflammation in RA is clinically relevant and conceptually important for understanding the pathophysiology of the disease and for the development of treatments that enable long-term remission. Cytokine-mediated processes such as the activation of T helper 2 cells by IL-4 and IL-13, the resolution of inflammation by IL-9, IL-5-induced eosinophil expansion, IL-33-mediated macrophage polarization, the production of IL-10 by regulatory B cells and IL-27-mediated suppression of lymphoid follicle formation are all involved in governing the regulation and resolution of inflammation in RA. By better understanding these immune-regulatory signalling pathways, new therapeutic strategies for RA can be envisioned that aim to balance and resolve, rather than suppress, inflammation.
          Article 0 comments Cited 203 times – based on 0 reviews     Review now
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            Molecular and Functional Neuroscience in Immunity

            Kevin J. Tracey, Sangeeta S Chavan, Valentin Pavlov (2018)
            The nervous system regulates immunity and inflammation. The molecular detection of pathogen fragments, cytokines, and other immune molecules by sensory neurons generates immunoregulatory responses through efferent autonomic neuron signaling. The functional organization of this neural control is based on principles of reflex regulation. Reflexes involving the vagus nerve and other nerves have been therapeutically explored in models of inflammatory and autoimmune conditions, and recently in clinical settings. The brain integrates neuro-immune communication, and brain function is altered in diseases characterized by peripheral immune dysregulation and inflammation. Here we review the anatomical and molecular basis of the neural interface with immunity, focusing on peripheral neural control of immune functions and the role of the brain in the model of the immunological homunculus. Clinical advances stemming from this knowledge within the framework of bioelectronic medicine are also briefly outlined.
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              Roles of inflammation, neurogenic inflammation, and neuroinflammation in pain

              Megumi Matsuda, Yul Huh, Ru-Rong Ji (2019)
              Inflammation is the body’s response to injury and infection, involving a complex biological response of the somatosensory, immune, autonomic, and vascular systems. Inflammatory mediators such as prostaglandin, pro-inflammatory cytokines, and chemokines induce pain via direct activation of nociceptors, the primary sensory neurons that detect noxious stimuli. Neurogenic inflammation is triggered by nerve activation and results in neuropeptide release and rapid plasma extravasation and edema, contributing to pain conditions such as headache. Neuroinflammation is a localized inflammation in the peripheral nervous system (PNS) and central nervous system (CNS). A characteristic feature of neuroinflammation is the activation of glial cells in dorsal root ganglia, spinal cord, and brain which leads to the production of proinflammatory cytokines and chemokines in the PNS and CNS that drives peripheral sensitization and central sensitization. Here, we discuss the distinct roles of inflammation, neurogenic inflammation, and neuroinflammation in the regulation of different types of pain conditions, with a special focus on neuroinflammation in postoperative pain and opioid-induced hyperalgesia.
              Article 0 comments Cited 148 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Quanzheng Chen
                Zhenshan Wang
                Journal
                Journal ID (nlm-ta): Medicine (Baltimore)
                Journal ID (iso-abbrev): Medicine (Baltimore)
                Journal ID (publisher-id): MD
                Title: Medicine
                Publisher: Lippincott Williams & Wilkins (Hagerstown, MD )
                ISSN (Print): 0025-7974
                ISSN (Electronic): 1536-5964
                Publication date Collection: 25 August 2023
                Publication date (Electronic): 25 August 2023
                Volume: 102
                Issue: 34
                Electronic Location Identifier: e34961
                Affiliations
                [a ] Department of Physical Education and Health, Guangxi Normal University, Guilin, China.
                Author notes
                * Correspondence: Shuna Zhang, Department of Physical Education and Health, Guangxi Normal University, Yanzhong Road No.1, Guilin 541006, China (e-mail: shuna0@ 123456163.com ).
                Author information
                https://orcid.org/0009-0001-2273-8327
                Article
                Accession ID: 00066
                DOI: 10.1097/MD.0000000000034961
                PMC ID: 10470699
                PubMed ID: 37653794
                SO-VID: a180b7e1-167d-4b4f-aad2-85580700b5cf
                Copyright © Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
                License:

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 27 March 2023
                Date revision received : 14 July 2023
                Date accepted : 4 August 2023
                Categories
                Subject: 7000
                Subject: Research Article
                Subject: Narrative Review
                Custom metadata
                OPEN-ACCESS TRUE

                Keywords: low back pain,lumbar spine,manual therapy,nerve mobilization,physical therapy
                Data availability:
                Keywords: low back pain, lumbar spine, manual therapy, nerve mobilization, physical therapy

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