Effects of spinal manipulation or mobilization as an adjunct to neurodynamic mobilization for lumbar disc herniation with radiculopathy: a randomized clinical trial

Key Points

1. Spinal mobilization with neurodynamics appears to be superior to spinal manipulation with neurodynamics for people experiencing lumbar disc herniation with radiculopathy.

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BACKGROUND & OBJECTIVE

Lumbar disc herniation with radiculopathy (DHR) is a diagnosis that is associated with disability, lost work productivity, and pain. Treatments may include surgery, epidural injections, and/or conservative care. While surgery may be more effective than conservative care in the short term, long-term outcomes were the same as conservative care (1). Conservative treatment may include spinal manipulative therapy (SMT), spinal mobilization (MOB), or neurodynamic mobilization (NM).

This study aimed to examine the long-term clinical effects of spinal manipulation or spinal mobilization as an adjunct to neurodynamic mobilization in people with DHR.

While surgery may be more effective than conservative care in the short term for Lumbar disc herniation with radiculopathy, long-term outcomes were the same as conservative care.

Neither spinal mobilization nor spinal manipulation needs to be included in the care plan for a person with lumbar disc herniation with radiculopathy.

METHODS

• In this single-blind, parallel-group randomized clinical trial, 20 subjects received SMT with NM and 20 subjects received MOB with NM (see video below).

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