Lumbar radiculopathy causes lower back and lower extremity pain that may be managed with neural mobilization (NM) techniques. This meta-analysis aims to evaluate the effectiveness of NM in alleviating pain and reducing disability in patients with lumbar radiculopathy. We hypothesized that NM would reduce pain and improve disability in the lumbar radiculopathy population, leveraging the statistical power of multiple studies. Electronic databases from their inception up to October 2023 were searched for randomized controlled trials (RCTs) that explored the impact of NM on lumbar radiculopathy. Our primary outcome measure was the alteration in pain intensity, while the secondary one was the improvement of disability, standardized using Hedges’ g. To combine the data, we employed a random-effects model. A total of 20 RCTs comprising 877 participants were included. NM yielded a significant reduction in pain intensity (Hedges’ g = −1.097, 95% CI = −1.482 to −0.712, p < 0.001, $I^2$= 85.338%). Subgroup analyses indicated that NM effectively reduced pain, whether employed alone or in conjunction with other treatments. Furthermore, NM significantly alleviated disability, with a notable effect size (Hedges’ g = −0.964, 95% CI = −1.475 to −0.453, p < 0.001, $I^2$ = 88.550%), particularly in chronic cases. The findings provide valuable insights for clinicians seeking evidence-based interventions for this patient population. This study has limitations, including heterogeneity, potential publication bias, varied causal factors in lumbar radiculopathy, overall study quality, and the inability to explore the impact of neural pathology on NM treatment effectiveness, suggesting opportunities for future research improvements.

Neuropathic pain presents a persistent therapeutic challenge, arising from diverse etiologies such as trigeminal neuralgia, postherpetic neuralgia, post-amputation pain, painful polyneuropathy, peripheral nerve injury pain, and painful radiculopathy. Given the limitations and side effects associated with pharmacologic treatments, interest in interventional therapies has surged. Herein, ultrasound guidance provides real-time, radiation-free visualization that enhances procedural accuracy and safety. This narrative review synthesizes current evidence on ultrasound-guided techniques—including nerve blocks, pulsed radiofrequency, hydrodissection, and peripheral nerve stimulation—in the management of neuropathic pain. These minimally invasive approaches demonstrate potential in providing significant and durable pain relief, enhancing functional outcomes, and reducing reliance on systemic medications. Notably, much of the existing literature comprises small-scale or observational studies and larger randomized controlled trials are therefore essential to confirm efficacy, define optimal treatment parameters, and inform clinical guidelines for broader adoption.

Patellofemoral pain syndrome (PFPS) is one of the most common etiologies of knee pain and might be relieved with lumbopelvic manipulation (LPM). This meta-analysis aimed to investigate the effects of LPM on pain reduction in patients with PFPS. Electronic databases were searched from inception to December 2023 for randomized controlled trials (RCTs) investigating the effects of LPM on PFPS. The primary outcome was the change in visual analog or numeric rating scale scores assessing pain. Ten studies comprising 346 participants were included. Significant pain reduction was noted in the LPM group (Hedges’ g = −0.706, 95% confidence interval [CI] = −1.197 to −0.214, p = 0.005, $I^2$ = 79.624%) compared with the control group. Moreover, pain relief was more pronounced when LPM was combined with other physical therapies (Hedges’ g = −0.701, 95% CI = −1.386 to −0.017, p = 0.045, $I^2$ = 73.537%). No adverse events were reported during the LPM. The LPM appears to be a safe and effective adjuvant therapy for pain reduction in patients with PFPS. Clinicians should consider adding LPM to other physical therapies (e.g., quadriceps muscle strengthening) during the management of these patients.

Background: The objective of this study was to investigate the effect of ultrasound-guided corticosteroid injection to the subacromial-subdeltoid bursa (SSB) and coracohumeral ligament (CHL) in treating adhesive capsulitis, with a particular focus on evaluating the potential benefits of regular electrotherapy and conventional rehabilitation exercises. Methods: A total of 29 patients with unilateral shoulder pain and restricted shoulder range of motion (ROM) were included. Corticosteroids were delivered to the subacromial-subdeltoid bursa (SSB) and coracohumeral ligament (CHL) through a single percutaneous injection. Group 1 consisted of 18 patients who received injections only, while Group 2 comprised 11 patients who received injections in combination with regular physiotherapy. Shoulder Pain and Disability Index (SPADI) scores and ROM were assessed before the injection, and again at 4, 8, and 12 weeks following the intervention. A multivariate mixed-effects model with repeated measurements was conducted for the variables. Results: Electrotherapy and traditional rehabilitation exercises did not enhance the effectiveness of this injection approach. Pain, upper extremity function, and ROM in all planes were all significantly improved with a corticosteroid injection to the CHL and SSB. Conclusions: Physiotherapy did not offer additional benefits when combined with ultrasound-guided corticosteroid injection to the CHL and SSB. The injection alone significantly improved pain, disability, and ROM in patients with adhesive capsulitis. Further research is required to optimize current physiotherapy with electrotherapy and traditional rehabilitation exercises after ultrasound-guided corticosteroid injections.

Background: Temporomandibular joint (TMJ) disorders are prevalent musculoskeletal conditions. Common therapies include TMJ manual therapy, TMJ exercise, and modalities such as low-level laser, therapeutic ultrasound, and transcutaneous electrical nerve stimulation (TENS). This study ranked TMJ manual therapy, TMJ exercise, low-level laser therapy, therapeutic ultrasound, and TENS for pain relief and improved maximal mouth opening (MMO) to strengthen evidence for clinical practice. Methods: PubMed, Scopus and Ovid MEDLINE were systematically searched from inception to March 2026 for randomized controlled trials evaluating TMJ manual therapy, TMJ exercise, low-level laser therapy, therapeutic ultrasound, and TENS for TMJ disorder. A frequentist network meta-analysis with a random-effects model was performed to compare treatment effects across interventions, with standardized mean differences calculated as the effect size. Treatment rankings were estimated using the surface under the cumulative ranking curve. Publication bias was assessed using funnel plots and Egger test. Results: This network meta-analysis demonstrated significant pain reduction with therapeutic ultrasound, TMJ manual therapy, TMJ exercise, and low-level laser therapy, and TENS. Therapeutic ultrasound showed the highest probability of providing pain relief, followed by TMJ manual therapy, low-level laser therapy, TMJ exercise, and TENS. For MMO, TMJ manual therapy, low-level laser therapy, therapeutic ultrasound, and TENS showed significant improvements, while TMJ exercise demonstrated a borderline effect. Based on the surface under the cumulative ranking curve rankings, TMJ manual therapy had the highest probability ranking, followed by therapeutic ultrasound. Conclusion: This network meta-analysis suggests that TMJ manual therapy had a higher probability ranking than TMJ exercise for reducing pain and improving MMO. Among physical modalities, therapeutic ultrasound and low-level laser therapy tended to rank higher than TENS. These findings may help inform clinical decision-making in the management of TMJ disorder. Future studies should further investigate the influence of treatment duration and TMJ disorder diagnostic subtypes.

This study aimed to evaluate the effects of core-inclusive physical training, either performed alone or combined with additional physical conditioning, on clubhead speed (CHS) in healthy golfers and to compare golf-specific swing-simulated core training (GSCT) with non-GSCT. Six primary electronic databases (PubMed, Embase, Cochrane CENTRAL, Web of Science, Scopus, PEDro) and Google Scholar were searched from inception to June 2026 for controlled trials. Continuous CHS outcomes were pooled using random-effects models as Hedges’ g. Nine trials (220 golfers) were analyzed. Overall core-inclusive physical training showed a small, statistically significant effect on CHS (Hedges’ g = 0.290, 95% CI: 0.031 to 0.549, p = 0.028; I² = 0.000%). Subgroup analysis indicated that interventions incorporating GSCT showed a numerically larger effect (Hedges’ g = 0.451, 95% CI: 0.073 to 0.830, p = 0.020) than non-GSCT (Hedges’ g = 0.148, 95% CI: −0.208 to 0.503, p = 0.416). However, meta-regression for between-subgroup differences did not reach statistical significance (Q = 1.31, p = 0.252). Certainty of evidence according to the GRADE framework was rated as low for overall CHS and very low for the GSCT subgroup training. In conclusion, conditioning practitioners may implement comprehensive core-inclusive physical training to enhance CHS, while considering GSCT as a promising yet exploratory strategy pending confirmation from larger randomized trials.