The aim of this study is to compare the effects of Sustained Natural Apophyseal Glides with and without Pilates on pain, range of motion and disability in patients with lumbar Disc Bulge.

Lumbar disc disease may occur when a disc in the low back area of the spine bulges or herniates between the bony areas of the spine. Lumbar disk disease causes lower back pain and leg pain and weakness that is made worse by movement and activity. Lumbar disc bulge is typically managed through a multidimensional approach that integrates various therapeutic techniques aimed at reducing symptoms and enhancing functional outcomes. The use of SNAGs has been shown to produce positive results such as decreased pain levels and increased mobility in previous studies. Overall physical conditioning can be improved by using a holistic approach that consists of controlled movements combined with breathing techniques and mindfulness. In order to treat lumbar disc bulge patients more effectively, it is important to understand how use and efficacy differ when applying SNAGs alone versus together with Pilates. Delving into how combining SNAGs and Pilates affects lumbar disc bulge patients contributes to an expanding body of proof advocating for a multimodal treatment.

Inclusion Criteria:

• Patient of both gender under the age of 40-60 year.
• Unilateral radiating pain through the course of sciatic nerve
• a duration of pain of at least 3 months
• Restricted lumbar range of motion.
• Subjects who can understand the instructions and are willing to participate in the study
• Positive slump test with positive pain location and positive pain descriptors.
• Passive Lumbar Extension If the patient experiences severe low back pain or if there is a feeling of heaviness on the lower back or a feeling as though the lower back were about to 'come off' the test is considered positive.
• Straight Leg Raise SLR test positive when it evokes radiating pain along the course of the sciatic nerve and below the knee between 30 and 70 degrees of hip flexion

Exclusion Criteria:

• History of trauma, dislocation and subluxation of lower extremity.
• Rheumatoid Arthritis
• Systemic diseases such as blood coagulation disorders, chronic pain syndrome, cancer, allergies fibromyalgia, systemic lupus erythematous, and psoriatic arthritis.
• Lumbar spine surgery patients.
• Malignancy
• neurologic disorders (e.g., trigeminal neuralgia or occipital neuralgia)
• clinical diagnosis of lumbar bilateral radiculopathy or myelopathy
• history of previous physical therapy intervention for the lumbar region in last 6 months