Effect of nerve mobilization techniques and spinal traction in patients with back pain radiating into lower limbs

Neural Mobilization plus Lumbar Traction arm: participants in this group received 12 sessions of lumbar spine traction for up to 12 days followed by neural mobilizations. Traction was applied for 20 minutes duration with an intermittent force of 50 per cent of body weight. Each participant also received two types of mobilizing techniques: Static opener and two-end sliders. For applying static opener participants were instructed to lie on their side with painful side uppermost and hips and knee were flexed to 90, they were requested to move towards the edge of the treatment bed so that their knees protrude forward hand’s breadth over the side of the plinth. Then participants were advised to slowly drape their legs over the edge of the bed hence producing contralateral lateral flexion on the symptomatic side. They held this position for up to 1 minute and repeat it thrice during each session. For administering two-ended slider patients were instructed to sit straight on the treatment table with their legs hanging and holding arms at their back. For the first slider, they have to flex their neck from neutral position to full flexion simultaneously flexing their both knees. During the second slider, they had to extend their neck from neutral position simultaneously extending their both knees. Each technique was performed 10 times per session. Both types of mobilizing techniques were employed one after another after the application of traction. Treatment was delivered by physiotherapists who had at least 2 years of clinical experience and trained in applying neural mobilizations. Each participant was also required to provide data about their disability level (Oswestry Disability Questionnaire) and pain (Numeric Pain Rating Scale) before first treatment session and one day after the commencement of the last session. Treatment was provided at outpatient physiotherapy facility.