Efficacy of Neural Mobilization on Low Back Pain with S1 Radiculopathy

Background: A definite conclusion about the effectiveness of neural mobilization on patients with radiculopathy can’t be reached because of the lacks of well designed randomized controlled trials. The purpose of the study to investigate the effects of neural mobilization on low back pain subjects with S1 radiculopathy. Methods: Sixty chronic low back pain subjects with S1 radiculopathy participated in this study. The participants were suffering from varying degrees of unilateral pain and paresthesia in the lumbosacral region and lower limb. The causes of radiculopathy were bulged disc, herniated disc or neuroforaminal stenosis at L5-S1 level.The participants were randomly assigned into two equal groups with 30 participants in each group. The experimental group received neural mobilization and conventional rehabilitation program in the form of infrared, ultrasonic and general exercises that involved stretching and strengthening exercises for the back muscles for 6 weeks. The control group received the same conventional rehabilitation program only for 6 weeks. The outcome measures were H-reflex latency, amplitude, and H/M ratio for assessing S1 nerve root function, visual analog scale (VAS) for assessing pain level, and Oswestry Disability Index (ODI) for assessing functional disability. All the participants were evaluated pre and post 6 weeks of treatment. Results: Both groups showed significant improvements in all measured variables after 6 weeks, but neural mobilization showed more beneficial and statistically significant effect in all measured variables than the control group. Conclusion: Neural mobilization technique is an effective intervention for reduction of pain, functional disability and enhancing physiological function of the nerve root in low back pain with lumbosacral radiculopathy.