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

Not Applicable

Not yet recruiting

• Conditions: Discogenic Pain; Sciatica

• Registration Number: NCT07050108
• Lead Sponsor: Cairo University

Brief Summary

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.

Detailed Description

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.

Study Timeline

• Status Verified: 2025-06
• Study First Submitted: 2025-06-25
• Study First Submitted QC: 2025-06-25
• Last Update Submitted: 2025-06-25
• Study Start: 2025-06-30
• Study First Posted: 2025-07-03
• Last Update Posted: 2025-07-03
• Primary Completion: 2025-08-01
• Study Completion: 2025-08-01

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 66

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.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
pressure pain threshold	up to four weeks	ALgometer offer real-time visual \& auditory feedback to control \& monitor applied pressure rates to measure pressure pain threshold.
pain intensity	up to four weeks	Sciatica Bothersomeness Index will be used to assess pain intensity. An index based on patients reporting of symptoms which reflects the troubled patient is going through with his sciatica symptoms. Items from the Sciatica Bothersomeness Index (0 = none to 6 = extremely) were used to establish values for paresthesia, weakness and leg pain.

Secondary Outcome Measures

Name	Time	Method
Range of motion assessment of straight leg raise	up to four weeks	A unilevel inclinometer will be used to assess the straight leg raise (SLR) test. From supine lying position on a flat plinth towards the side of the examiner, with the neck in a neutral position. The examiner places one hand under the Achilles tendon and the other hand held the inclinometer. The inclinometer must be held in a vertical position during the SLR test by the examiner's hand between the index and the middle fingers and center of inclinometer will be positioned on the lower third of tibia. The leg will be lifted perpendicular to the point at which the patient expressed the perception of pain and the therapist will prevente any knee flexion. The angle of hip flexion during SLR will be measured
disability	up to four weeks	Roland-Morris Disability Questionnaire will be used to assess disability.The RMQ is a 24-item patient-reported outcome measure that inquires about pain-related disability resulting from LBP and discogenic sciatica .total RMQ score ranging from 0 to 24; higher scores represent higher levels of pain-related disability