None listed
Conditions
Brief summary
Radicular pain originated in lumbar and sacral plexus is a common problem in clinical practice. It is usually related with problems in lumbar spine, specially with disc herniations which induce compression in nerve roots. There are some techniques and methods aimed to reduce low back pain and sciatica pain, like physical therapy, exercises or pharmacologic treatment. Physical exercise, and mainly motor control training in lumbopelvic region has shown great effects in lumbar spine problems like chronic low back pain. Among the techniques of physiotherapy for neuropathic pain, neurodinamic mobilization seems to be an useful technique in order to reduce pain and other symptoms. The objective of the this trial is measure changes in patients treated with both techniques in some parameters: pain (assessed with Visual Analogic Scale), neuropathic pain characteristics (LANSS Questionnarire), nerve mechanosensitivity or algometry (pain threshold pressure and Straight Leg Raise Test) and low back pain disability (Roland Morris Questionnaire). Trial will be carried out with around 30 patients with radicular pain in lower limb (sciatica) and with lumbar or sacral disc herniation in L4-L5-S1 level. Patients will be allocated in two groups, the control group (n=15) which receive a motor control training for lumbopelvic region, and the experimental group (n=15) which receive the same training and they will receive also neurodinamic mobilization in lower limb nerves. Both groups treatments will be given for 2 months, one session per week. Some measurements will be carried out previous and after session (VAS, Straight Leg Raise Test and algometry). In addition, LANSS Questionnaire and Roland-Morris will be carried out previous to the beginning of the intervention, at the middle and after the intervention. It will be measured again 2 months after the end of the treatment.
Interventions
In the experimental group a physiotherapist will teach motor control exercise in lumbopelvic region. In addition, patients will receive neurodynamic mobilization of sciatic nerve.
Sessions will be individual (one-on-one consultation), and the frequency will be 1 half-hour session per week for 8 weeks.
Patients will be treated with mobilization of sciatic nerve, using oscilatory movements with knee extension, hip flexion and ankle dorsiflexion. Physiotherapist could use hip abduction and adductio
In the experimental group a physiotherapist will teach motor control exercise in lumbopelvic region. In addition, patients will receive neurodynamic mobilization of sciatic nerve. Sessions will be individual (one-on-one consultation), and the frequency will be 1 half-hour session per week for 8 weeks. Patients will be treated with mobilization of sciatic nerve, using oscilatory movements with knee extension, hip flexion and ankle dorsiflexion. Physiotherapist could use hip abduction and adduction if necessary. Motor control exercises will be taught by physiotherapist. He´ll teach the isolated transverse abdominal muscle contraction to the patients. After that patients will learn multifidus contraction too. Then, patients will perform some exercises simultaneously contracting these deep muscles. Patients will receive some information about the exercise in order to perform these exercises all the week, between every session. Participants are asked to practice the exercises at home once daily for 20 minutes over the 8 week intervention period. There are not strategies used to monitor adherence to the intervention
Sponsors
Gustavo Plaza
Study design
Allocation
Randomised controlled trial
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject)
Eligibility
Sex/Gender
All
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
Patients aged between 18 and 60 years old. L4-L5-S1 disc herniation with pain in lower limb. At least 3 months with pain Positive Straight Leg Raise Test No additional treatment while study is carrying out
Exclusion criteria
Disc herniations in other spinal levels Other spinal pathologies like tumours or spondylolisthesis Acute pain Patients treated with other treatments.
Outcome results
None listed