Combined Effects of Neurodynamics and Lumbar Traction on Sciatica Due to Degenerative Disc Disease

Abstract

Introduction: Disc space variation, neural mobility and their relation to sciatica symptoms in degenerative disc disease is still a challenging area to work, Sciatica is a common diagnosis causing the pain, weakness, numbness or tingling in the leg, with compromise in quality of life, functional activity. , lifetime incidence of sciatica varying from 13% to 40%, annual incidence ranges from 1% to 6 % in India. Materials and Methods: 42 subjects with sciatica due to degenerative disc disease were included and 35 completed study, with age >25 years, both sexes. Group1 (G1): control, Group2 (G2) received neurodynamics treatment, Group 3 (G3) received lumbar traction, Group 4 (G4) received both neurodynamics and lumbar traction. Efficacy of treatment of experimental groups (G2,3,4) was assessed on 1 st day and at the end of 2 week with 1. Magnetic resonance imaging (MRI) for disc parameters, 2. pain by VAS, 3. Range of motion by goniometer and 4. functional rating scales sciatica bothersomeness index, maineseattle back questionaaire and Hopkins symptom checklist-25. The data subjected to statistical analysis using descriptive and inferential statistics. Results: Combined group (G4) showed better outcome in all parameters than neurodynamics (G2) or traction alone (G3). Traction alone Group (G3), combined group (G4) have got similar changes in MRI disc parameters better than neurodynamics alone group (G2). Discussion: Findings suggests that 2 weeks treatment showed variable improvements in all groups on MRI of L4-L5 and L5-S1, functional outcome, pain and ADL activities. Effectiveness of lumbar traction is evident in group 3 and 4, effectiveness of Neurodynamics is evident in group 2, only in group 4 all parameters improved this can be attributed to combined effect. Conclusion: Neurodynamics may be effective on reducing the mechanosensitivity of nerve and traction may be useful for decompression of segment. In order to address pain, function and ADL activities combination of traction and Neurodynamics showed better results than traction or Neurodynamics alone in this study.