03, 95% CI 0.58 to 1.84). This randomised controlled trial examined the benefits and harms of neural tissue management as an intervention for nerve-related neck and arm pain. Low NNTs and moderate standardised mean differences show that neural tissue management produced clinically important benefits for participant-reported improvement, pain intensity, and activity limitations at short-term follow-up when compared to advice to remain active. There was no evidence to suggest that neural tissue management was harmful. The prevalence of worsening was similar for the experimental and control groups, and

no participants had to stop neural tissue management early because of an exacerbation that they and the physiotherapist related click here to treatment. Although several participants experienced adverse events that they related to neural tissue management, these events would be categorised as ‘mild’ because they did not require additional treatment, usually lasted < 24 hours, had minimal impact on daily activities, and did not reduce a participant's chance of improving with neural tissue management (Carlesso et al 2011, Carnes et al 2010). The proportion of participants assigned to neural tissue management

who experienced an adverse event and the characteristics of these events are similar to those reported previously for manual therapy for patients with neck pain http://www.selleckchem.com/products/PD-98059.html (Hurwitz et al 2004). The results of this trial enable physiotherapists to have informed discussions with patients about the short-term benefits and harms of neural tissue management for nerve-related neck and arm pain. Standardised mean differences for pain were similar to results from the trial by Allison and colleagues (2002) (≥ 0.7 versus 0.71), while those for activity limitations were larger (≥ 0.6 versus 0.34) (Gross et al 2004). The consistently favourable results for neural tissue management support the hypothesis that the lack of statistical significance in this previous trial was due to the

small sample.limitations of our study. Time constraints The size and source of the sample, comparison to advice to remain active, and short-term enough follow-up are potential limitations of our study. Time constraints prevented enrolment of the a priori sample of 84 participants. Although we anticipated that approximately 10% of volunteers would enter the trial, the response to each recruitment advertisement was lower than expected. Enrolment stopped at 60 participants because data collection could not extend beyond two years. The concern with early stoppage of a trial is that any treatment effect may reflect a ‘random high’ in the data rather than the ‘true’ effect ( Moher et al 2010).