Neural mobilization versus somatosensory motor control in treatment of chronic low back pain with unilateral sciatica: a randomized clinical trial.

Abstract

Background: Low back pain is one of the most prevalent musculoskeletal illnesses in contemporary culture. The greater demand for orthopedic physical therapy identifies the need for more evidence-based techniques. Purpose: This research compared the efficacy of neural mobilization and somatosensory motor control training on balance, nerve excitability, and lumbar range of motion in individuals with persistent low back pain and unilateral sciatica. Methods: Forty-five male and female patients with persistent lower back pain and unilateral sciatica were included in this investigation. They were between thirty and fifty years old. They were randomly divided into three treatment groups (groups A, B, and C) of equal size. Group A received a traditional physiotherapy program (Transcutaneous Electrical Nerve Stimulation (TENS), hot pack, passive stretching, and core strengthening). Group B received the same traditional program, followed by sciatic neural slider mobilization. Group C received the traditional program followed by somatosensory motor control training, which consisted of proprioceptive neuromuscular facilitation (PNF), somatosensory exercises, and vestibular exercises. Results: All groups had statistically significant improvements in all outcome measures (p < 0.05) post treatment. No significant variations were recorded among the three groups in respect to balance scores, lumbar range of motion, and pain (p > 0.05) post treatment. Group B and C similarly improved and higher than group A in respect to nerve excitability (Hlatency). Group B improved significantly higher than group A and C in respect to function (P < 0.05). Conclusion: Adding the neural mobilization and/or somatosensory motor control training to traditional physiotherapy program is beneficial in management of individuals with persistent lower back discomfort and unilateral sciatica.