Efficacy of Multimodal Rehabilitation Protocol with High-Force Machine Spinal Decompression Therapy in Chronic Low Back Pain with Sciatica Due to Lumbar Disc Herniation: A Pre–Post Observational Study

Background: Chronic low back pain (CLBP) with sciatica caused by lumbar disc herniation is a common and disabling condition. Combined therapeutic protocols that include high force machine spinal decompression therapy (SDT), infrared therapy, and interferential therapy are increasingly used in clinical practice, although evidence in chronic populations remains limited. Because this study did not include a control group, only observed pre–post changes can be reported. This study primarily aimed to assess observed changes in pain intensity following a multimodal therapy protocol in adults with chronic lumbar radiculopathy. Methods: A pre–post observational study was conducted in 234 adults with chronic lumbar radiculopathy lasting ≥12 weeks and MRI confirmed disc herniation at L4–L5 and/or L5–S1. Participants completed ten treatment sessions delivered twice weekly over five weeks. Each session included infrared therapy, high force SDT, and interferential therapy. Pain intensity (VAS 0–10) was measured before the first and before the tenth session. Results: Pain intensity decreased significantly after treatment (Wilcoxon W = 18,830, p < 0.001), with a mean reduction of 2.5 points, exceeding the minimal clinically important change threshold, and with a very large effect size (rank biserial correlation = 0.991). No significant gender differences were observed. Baseline pain (β = 0.312, p < 0.001) and age (β = 0.145, p = 0.020) independently predicted post-treatment pain (R2 = 0.129). Conclusion: A reduction in pain intensity was observed after five-week combined therapy protocol. Due to the absence of a control group and the simultaneous use of multiple modalities, no causal conclusions can be drawn, nor can improvements be attributed to SDT alone. Randomized controlled trials with functional outcomes and long-term follow-up are warranted.