Precautions and Contraindications to Neural Tension Testing and Treatment

By Carolyn Kisner PT, MS and Lynn Allen Colby PT, MS on February 23rd 2009

Prevention

These maneuvers may be used to prevent restrictive adhesions from developing if done early during treatment after an acute injury or surgery.

Precautions and Contraindications to Neural Tension Testing and Treatment

There is incomplete scientific understanding of the pathology and mechanisms occurring when mobilizing the nervous system. Use caution with the stretch force; neurological symptoms of tingling or increased numbness should not last when the stretch is released. The clinician should always use caution and perform a thorough systems review and screening examination to rule out “red flag” conditions prior to neural tension testing and treatment.

Precautions:
• Know what other tissues are affected by the positions and maneuvers.
• Recognize the irritability of the tissues involved and do not aggravate the symptoms with excessive stress or repeated movements.
• Identify whether the condition is worsening and the rate of worsening. A rapidly worsening condition requires greater care than a slowly progressing condition.
• Use care if there is an active disease or pathology affecting the nervous system.

Contraindications:
• Acute or unstable neurological signs
• Cauda equina symptoms related to the spine including changes in bowel or bladder control and perineal sensation
• Spinal cord injury or symptoms
• Neoplasm and infection
• Watch for signs of vascular compromise. The vascular system is in close proximity to the nervous system and at no time should show signs of compromise when mobilizing the nervous system.

Buy the Book that holds this excerpt: Therapeutic Exercise: Foundations and Techniques (Therapeutic Exercise: Foundations & Techniques)

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Tags: contraindications, Neural, Precautions

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