Neural mobilization in cervicogenic headache: a scoping review of current evidence.

BACKGROUND

Neural mobilization has increasingly been incorporated into physiotherapy management for cervicogenic headache (CGH); however, evidence regarding its clinical effectiveness remains limited. This scoping review aimed to explore and map the existing evidence on neural mobilization in the management of CGH, with emphasis on pain, headache-related disability, and functional outcomes.

METHODS

A scoping review was conducted using PubMed (MEDLINE), PEDro, ScienceDirect, and the Cochrane Library to identify studies involving adults with CGH receiving neural mobilization or neurodynamic interventions. Outcomes assessed included pain, headache frequency, disability, cervical posture, and quality of life.

RESULTS

From 699 identified records, five studies comprising one pilot randomized controlled trial, two comparative clinical studies, and two case reports involving 142 participants were included in the review. Across the included studies, interventions incorporating neural mobilization were associated with improvements in pain intensity, headache frequency, headache-related disability, cervical posture, cervical range of motion, and quality of life. Neural mobilization was predominantly delivered as part of multimodal physiotherapy programs, particularly alongside postural correction and other physiotherapy interventions. However, the evidence was limited by the small number of studies, methodological heterogeneity, variation in neural mobilization protocols, and limited long-term follow-up.

CONCLUSION

Current evidence indicates that neural mobilization is a promising adjunct within multimodal physiotherapy management of CGH. However, the available evidence is insufficient to establish its independent therapeutic effectiveness. Further well-designed studies using standardized neural mobilization protocols, appropriate comparator groups, and longer follow-up are required to strengthen the evidence base.