Natural apophyseal glides (NAGS) refers to a spinal
physical therapy treatment technique developed by Brian Mulligan.
[Brian R. Mulligan (2004). ''Manual therapy: NAGS, SNAGS, MWMS etc.'' (5th Ed). Plane View Services Ltd. ]
Technique
NAGS involves a mid to end-range
facet joint mobilisation applied anterocranially along the plane of treatment within the desired joint, combined with a small amount of manual traction. The purpose of this treatment is to increase movement within the spine, and decrease symptomatic pain.
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Sustained natural apophyseal glides
Sustained natural apophyseal glides (SNAGS) are a separate technique involving a combination of a sustained facet glide with active motion, which is then followed by overpressure.[
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Clinical evidence
A 2010 study concluded that whilst both NAGS and SNAGS showed signs of effectiveness, SNAGS demonstrated greater statistically significant efficacy over NAGS in reducing pain and disability in subjects with chronic neck pain
Neck pain, also known as cervicalgia, is a common problem, with two-thirds of the population having neck pain at some point in their lives.
Neck pain, although felt in the neck, can be caused by numerous other spinal problems. Neck pain may arise ...
. Another study suggested that Mulligan's mobilisation (i.e. NAGS and SNAGS), Maitland's mobilisation and the McKenzie approach were all effective in relieving pain and improving range of motion in cases of chronic cervical spondylosis with unilateral radiculopathy
Radiculopathy, also commonly referred to as pinched nerve, refers to a set of conditions in which one or more nerves are affected and do not work properly (a neuropathy). Radiculopathy can result in pain (radicular pain), weakness, altered sens ...
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A 2008 randomised controlled trial by Reid et al. suggested a statistically significant correlation between SNAGS treatment and reduced dizziness, cervical pain and disability caused by cervical dysfunction, whilst another randomised controlled trial in 2007 by Hall et al. suggested that a self-sustained C1-C2 SNAG technique was effective in managing cervicogenic headache Cervicogenic headache is a type of headache characterized by chronic hemicranial pain referred to the head from either the cervical spine or soft tissues within the neck. The main symptoms of cervicogenic headaches include pain originating in the ne ...
. A 2008 study by Moutzouri et al. suggested that SNAG mobilisation did not demonstrate significant effectiveness to increase the range of motion in patients with low back pain
Low back pain (LBP) or lumbago is a common disorder involving the muscles, nerves, and bones of the back, in between the lower edge of the ribs and the lower fold of the buttocks. Pain can vary from a dull constant ache to a sudden sharp feel ...
.[Moutzouri, M., Billis, E., Strimpakos, N., Kottika, P., & Oldham, J. A. (2008). The effects of the Mulligan Sustained Natural Apophyseal Glide (SNAG) mobilisation in the lumbar flexion range of asymptomatic subjects as measured by the Zebris CMS20 3-D motion analysis system. ''BMC Musculoskeletal disorders'', 9(1), 131.]
See also
* Passive accessory intervertebral movements
* Passive physiological intervertebral movements
References
{{reflist
Physical therapy