NAGS (Natural Apophyseal Glides)

Brian Mulligan: “NAGS” are mid to end-range facet joint mobilisations that are applied antero-cranially along the treatment planes of the joints selected. They are graded according to the tolerance of the patient. They must never cause pain, maybe very slight discomfort. The patient is always seated which is a most convenient starting position. This is much more acceptable than prone lying especially with kyphotic patients. They should be combined with a minute manual traction which renders them more comfortable.

They are used to increase spinal movement and decrease the pain associated with it. They are very useful in the elderly when applied with “tender loving care”. For the patient with grossly restricted cervical movement, they are a godsend assuming that the loss of movement is not due to serious structural injury or other contraindicated pathology.

They are also a good test for irritability. If a technique so subtle and gentle cannot be undertaken without pain, then beware! To me it would mean that other forms of manual therapy would be contraindicated. Soreness after manipulative procedure will usually be relieved by “NAGS”. They are often used in conjunction with “SNAGS”. “

Source:  Manual Therapy, NAGS, SNAGS, MWMS etc. by Brian R Mulligan, 7th edition.

Watch video clip: A.1.NAGS

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