Effects of Adding a Neurodynamic Mobilization to Motor Control Training in Patients With Lumbar Radiculopathy Due to Disc Herniation

Abstract

Objective The aim of the study was to investigate the effects of the inclusion of neural mobilization into a motor control exercise program on pain, related disability, neuropathic symptoms, straight leg raise, and pressure pain threshold in lumbar radiculopathy. Design This is a randomized clinical trial. Methods Individuals with low back pain, with confirmed disc herniation, and lumbar radiculopathy were randomly assigned to receive eight sessions of either neurodynamic mobilization plus motor control exercises (n = 16) or motor control exercises alone (n = 16). Outcomes included pain, disability, neuropathic symptoms, straight leg raise, and pressure pain threshold at baseline, after four visits, after eight visits, and after 2 mos. Results There were no between-groups differences for pain, related disability, or pressure pain threshold at any follow-up period because both groups get similar and large improvements. Patients assigned to the neurodynamic program group experienced better improvements in neuropathic symptoms and the straight leg raise compared with the motor control exercise group (P < 0.01). Conclusions The addition of neurodynamic mobilization to a motor control exercise program leads to reductions in neuropathic symptoms and mechanical sensitivity (straight leg raise) but did not result in greater changes of pain, related disability, or pressure pain threshold over motor control exercises program alone in subjects with lumbar radiculopathy. Future trials are needed to further confirm these findings because between-groups differences did not reach clinically relevance.

Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature

“…Neural mobilization is a type of technique aimed at healing neural tissue which is considered to be one of the main problems in radiculopathy after mechanical compression [ 55 ]. Nerve root will become impeded when is overstretched, or its blood supply is limited due to compression for a significantly long time, or both.…”

Lumbopelvic Stabilization Exercises and McKenzie Method in Low Back Pain Due to Disc Protrusion. A Blind Randomized Clinical Trial

“…This disorder relates to age, gender, prolonged workload, trauma, and pregnancy (4). Lumbar intervertebral disc protrusion is one of the most common orthopedic conditions, producing, in many cases, low back pain that radiates to the lower limbs (5,6). Lumbar radiculopathy may be the result of a lumbar disc protrusion or hernia that can irritate a sacral plexus trunk, leading to intraneural inflammation (6).…”

“…Lumbar intervertebral disc protrusion is one of the most common orthopedic conditions, producing, in many cases, low back pain that radiates to the lower limbs (5,6). Lumbar radiculopathy may be the result of a lumbar disc protrusion or hernia that can irritate a sacral plexus trunk, leading to intraneural inflammation (6). A protruding or herniated degenerated disc can cause paresthesia and weakness in the lower limbs, in addition to pain (6).…”

“…Lumbar radiculopathy may be the result of a lumbar disc protrusion or hernia that can irritate a sacral plexus trunk, leading to intraneural inflammation (6). A protruding or herniated degenerated disc can cause paresthesia and weakness in the lower limbs, in addition to pain (6). In the worst cases, lumbar radiculopathy can be chronic, resulting in pain, disability, and substantial burden in the long run (6).…”

“…A protruding or herniated degenerated disc can cause paresthesia and weakness in the lower limbs, in addition to pain (6). In the worst cases, lumbar radiculopathy can be chronic, resulting in pain, disability, and substantial burden in the long run (6). This condition leads to health-related socioeconomic consequences that directly affect well-being and quality of life (5,7).…”