Effect of Sciatic Nerve Neurodynamic Sliding on Pain, Disability, and Balance in Patients With Lumbar Radiculopathy

Effect of Sciatic Nerve Neurodynamic Sliding Technique on Pain, Disability, and Balance in Patients With Lumbar Radiculopathy

This study will be conducted to evaluate the effect of sciatic nerve slider mobilization on pain intensity. Also, to evaluate the impact of sciatic nerve mobilization on functional disability, and to determine the influence of sciatic nerve slider neurodynamics on functional balance performance.

Radicular pain in lumbar radiculopathy is a mixture of nociceptive and neuropathic component. Several conservative treatments are available to treat lumbar radiculopathy: moderate evidence (Level B) of effectiveness for the conservative treatment: patient education and self-management, McKenzie method, mobilization and manipulation, exercise therapy, traction (short-term outcomes), neural mobilization, and epidural injections. Two interventions were identified to have weak evidence of effectiveness (Level C): traction for long-term outcomes and dry needling. Three interventions were identified to have conflicting or no evidence (Level D) of effectiveness: electro-diagnostic-based management, laser and ultrasound, and electrotherapy. The efficacy of individual treatment is controversial; a multimodal approach is recommended because it is more effective. However, little high-quality evidence supports the use of conservative treatment.

As well as being amongst the manual therapy techniques recommended to improve patients' pain and disability, neural mobilization (NM) has also been advocated as an analgesic treatment option. NMs are techniques that involve a specific sequence of joint movements to mobilize the involved peripheral nerve in order to enhance nerve gliding and reduce the neural mechanosensitivity.

This study will provide further insight into the efficacy of sciatic nerve neurodynamic Slider technique in reducing pain, improving functional outcomes, and balance, offering a cost-effective management strategy for affected individuals.

Inclusion Criteria:

• Chronic unilateral lumbar painful radiculopathy (duration ranged from 3 to 18 months).
• During the evaluation session, repeated lumbar movements did not improve or worsen lower extremity symptoms.
• Positive straight leg raise (SLR) response. A positive SLR test was defined as the presence of both of these findings: (1) the test reproduced the patient's symptoms and (2) the symptoms decreased with the ankle plantar flexion component of the test.
• Unilateral Pain radiating below the knee, with leg pain equal to or more severe than the accompanying back pain.
• The presence of paresthesia such as pins and needles or numbness in the affected limb, along with neurological deficits-whether motor, sensory, or reflex-that corresponded to the dermatome or myotome of the affected nerve root.

Exclusion Criteria:

• Systemic diseases such as autoimmune and metabolic diseases.
• Previous Lumbar Spine surgery.
• Lumbar spine stenosis.
• Spinal deformity.
• Spinal fracture.
• Bilateral lower extremity symptoms.
• Steroid injection or use of anti-inflammatory medications within two to four weeks prior to study commencement.