Neurodynamic Moblization Versus Mulligan on Pain and Functional Abilities in Patients With Chronic Discogenic Sciatica

Effect of Neurodynamic Mobilization Versus Mulligan on Pain and Functional Abilities in Patients With Chronic Discogenic Sciatica

The purpose of the present study to compare between the effect of neurodynamic moblizaton and Mulligan SNAG's moblization on patients with chronic unilateral discogenic sciatica.

Sciatica is a common problem in patients suffer from lumbar disc prolapse with an incidence of five cases per 1000 adults in developed countries . Sciatica causes significant disability. When applying neurodynamics, tension occurs in the nervous system, and pressure within the nerve increases due to the decrease of the cross-sectional area, and the axonal transport system lengthens the sciatic nerve after shortening because of the influence of the surrounding related structures and hamstring flexibility . After extention of the nerve and muscle, muscle performance is improved because of increases in the number of muscle fiber segments and cross-sectional area of muscle fibers.The majority of the research concerned with SNAG techniques has concentrated on the study of peripheral joints and the cervical region. Few studies have been concerned with the effects of SNAG on the lumbar spine. The rest of the available research was in the form of case reports or case series. Only 5 trials have investigated different effects of the SNAG technique when applied to the lumbar region. This study will improve the conservative treatment for sciatica and will decrease the cost of treatment and disability of the patient.

Inclusion Criteria:

• All the patients diagnosed as lumbar radiculopathy (L5-S1) for at least six months. Diagnosis was confirmed by physical, neurological examination (motor assessment, sensory assessment, reflexes) and radiological assessment (CT or MRI).
• All patients has second grade of disc bulge which will detect from T2 axial view of MRI according to Fardon and Milette
• All patients has unilateral radiculopathy and pain in the distribution of scaitic nerve.
• The age of the patients will range from 35 to 50years . Their body mass index will range between( 22-25)

Exclusion Criteria:

• Bilateral and multilevel disc prolapse or bilateral radtadiating pain
• acute pain (pain less than three months).
• Presence of active infection in lumbar spine.
• Any other spinal deformities.
• Postoperative cases.
• Cauda equine lesion.
• Neoplasmic.
• Spinal stenosis.
• Mechanical low back pain.
• Failed back syndrome.