A Comparative Analysis of Neural Mobilization Techniques and Conventional Physical Therapy for Sciatica Pain Management in Lumbar Radiculopathy

Background: Lumbar radiculopathy (LR), often manifesting as sciatica, is a prevalent and debilitating condition characterized by neuropathic pain radiating along the sciatic nerve. While conventional physical therapy (CPT) remains a cornerstone of conservative management, the efficacy of targeted neural mobilization techniques (NMT) is a growing area of investigation. This study aimed to compare the effectiveness of NMT versus CPT on pain, disability, and functional outcomes in patients with sciatica due to LR. Methods: A randomized controlled trial was conducted with 60 participants diagnosed with LR. Participants were allocated to either an NMT group (n=30), receiving slider and tensioner techniques for the sciatic nerve, or a CPT group (n=30), receiving a standardized protocol of lumbar stabilization exercises, stretching, and electrotherapy. The primary outcome was pain intensity measured by the Visual Analogue Scale (VAS). Secondary outcomes included disability, measured by the Oswestry Disability Index (ODI), and lumbar range of motion (ROM). Assessments were performed at baseline, 4 weeks, and 8 weeks post intervention. Results: Both groups demonstrated significant improvements in all outcome measures over time (p<0.05). However, the NMT group exhibited significantly greater reductions in VAS scores (Mean Difference at 8 weeks: -2.4, 95% CI: -3.1 to -1.7, p<0.001) and ODI scores (Mean Difference at 8 weeks: -12.8%, 95% CI: -16.1 to -9.5, p<0.001) compared to the CPT group at the 4- and 8-week follow-ups. Improvements in straight leg raise (SLR) ROM were also significantly superior in the NMT group. Conclusion: Neural mobilization techniques were more effective than conventional physical therapy alone in reducing pain and disability and improving functional outcomes in patients with sciatica from lumbar radiculopathy. Integrating NMT into standard rehabilitation protocols should be considered for optimal management. DOI: https://doi.org/10.59564/amrj/03.04/007