Impact of non-surgical spinal decompression therapy on disc morphology, pain, and disability in lumbar radiculopathy: A Randomised controlled trial

The traditional physiotherapy protocol consists of several modalities applied sequentially within the same treatment session. Each session begins with the application of hot moist heat at a temperature of 40–45°C for 15 minutes to promote tissue relaxation and increase blood flow. This is followed by Transcutaneous Electrical Nerve Stimulation (TENS) using a conventional mode. Conventional TENS is applied at a frequency of 80–100 Hz, with a pulse duration of 50–100 microseconds, in continuous mode. The intensity is set at a sensory level without eliciting muscle contraction. Electrodes are placed paraspinally at the affected lumbar level, and the treatment is delivered for 15 minutes. The primary purpose of this modality is pain modulation through the gate control mechanism. Ultrasound therapy is then applied to the lumbar paraspinal muscles using a frequency of 1 MHz in continuous mode, with an intensity of 0.9 W/cm² for 7 minutes, utilizing a 4 cm² applicator head. This intervention is intended to increase tissue temperature and reduce muscle spasm. In the experimental group, spinal decompression therapy is additionally administered using the SpineMED decompression system for 30 minutes. The applied traction force ranges between 10–15% of the patient’s body weight. All modalities are delivered consecutively within the same session and not simultaneously. In the control group, the sequence of interventions is hot moist heat, followed by TENS, and then ultrasound. In the experimental group, the same sequence is followed, with the addition of spinal decompression therapy at the end of the session. All patients receive five treatment sessions per week, totaling 20 sessions over a period of four weeks. Adherence to the intervention is monitored through session attendance and systematic recording within the treatment system.