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 (22 people in each group): 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 straight leg raise range of motion (SLR ROM), were assessed at baseline, after four weeks of treatment, and after a six-week follow-up. Results: 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 visual analog scale, Oswestry Disability Index, and SLR ROM compared to other groups. SMWLM may be a better viable choice in conservative management of lumbar PIVD.