Effect of manual therapy on pain, disability and neural mobility in patients of lumbar prolapsed intervertebral disc: a randomized controlled trial

Introduction
Lumbar prolapsed intervertebral disc (PIVD) is a common health issue affecting young and middle-aged populations. The aim of the present study was to determine the effect of manual therapy interventions on pain, disability, and neural mobility in lumbar PIVD patients.

Material and methods
Eighty-eight participants were assigned to four groups (n = 22 in each); “Spinal Mobilization with Leg Movement” (SMWLM) group, “High-Velocity Low Amplitude” (HVLA) thrust group, “Neural Mobilization” (NM) group and “Control Treatment” (CT) group. The outcomes measures, viz. changes in pain, disability, and SLR ROM (“straight leg raise range of motion”), were assessed at baseline, after four weeks of treatment, and after a six-week follow-up.

Results
Data analysis was performed using SPSS 21.0 software. The greatest mean improvement was seen in the SMWLM group, with a VAS score of 6.05 ± 1.32, compared to the HVLA group (3.68 ± 0.75), NM group (3.2 ± 0.62) and CT group (1.91 ± 1.22), ODI score of 15.65 ± 2.43 compared to the HVLA group (11.89 ± 1.29), NM group (10.85 ± 1.53) and CT group (3.77 ± 2.43) and a SLR ROM score of 15.06 ± 3.1 compared to the HVLA group (7.89 ± 2.21), NM group (7.07 ± 2.58) and CT group (1.59 ± 2.58).

Conclusions
SMWLM group showed the most significant mean change for VAS (“Visual analog scale”), ODI (“Oswestry Disability Index”), and SLR ROM compared to other groups. SMWLM may be a better viable choice in conservative management of lumbar PIVD.