Effects of Neural Mobilization Combined With Manual Therapy on Infrared Thermography, Inflammatory Markers and Clinical Outcomes in Patients With Lumbar Disc Herniation: A Randomized Controlled Clinical Trial

Summary

The objective of this randomized controlled clinical trial is to evaluate whether manual therapy combined with neural mobilization can improve pain, functional impairment, quality of life, inflammatory markers, and infrared thermographic findings in patients with lumbar disc herniation. The study subjects consist of 72 patients with lumbar disc herniation (aged 18-65 years, with unilateral lumbar radicular symptoms).

The primary questions it aims to address are:

1. In patients with lumbar disc herniation, is manual therapy combined with neural mobilization more effective than manual therapy alone in relieving pain and improving functional impairment?
2. Can manual therapy combined with neural mobilization improve patients' quality of life, inflammation-related markers (IL-6 and TNF-α), and body temperature changes detected by infrared thermography?

The researchers compared:

* Experimental group: manual therapy combined with neural mobilization (36 cases)
* Control group: manual therapy with sham neural mobilization (36 cases)

to determine whether adding neural mobilization can provide additional therapeutic effects, including better pain relief, functional recovery, and improvement in related physiological indicators.

Participants will:

* Receive a 3-week course of treatment, totaling approximately 11 sessions.
* Undergo standardized manual therapy, including lumbar mobilization and soft tissue therapy, to help relieve pain and improve mobility.
* Receive additional treatment according to group assignment:
* The experimental group will receive sciatic nerve mobilization through gentle, controlled leg movements to improve nerve function and reduce nerve sensitivity.
* The control group will receive lumbar traction therapy to relieve lumbar stress.
* Be assessed before and after treatment, including pain scores, functional impairment scores (ODI), quality of life surveys (SF-12), infrared thermography examinations, and blood tests for inflammatory markers.

Conditions

• Herniated Disc
• Sciatica Due to Intervertebral Disc Disorder

Interventions

BEHAVIORAL

Neural Mobilization

Neural mobilization will be performed using neurodynamics techniques, aiming to improve neural activity and reduce neural mechanosensitivity. The intervention will be conducted over a period of three weeks.

BEHAVIORAL

Sham Neural Mobilization

The posture and duration of pseudo neural stretching therapy do not produce the expected neurodynamic effects.

BEHAVIORAL

Manual Therapy

Participants in both groups will receive standardized manual therapy targeting the lumbar spine. The intervention includes lumbar posterior-to-anterior (PA) mobilization and soft tissue mobilization techniques applied to the lumbar paraspinal muscles, gluteal muscles, piriformis, and proximal hamstrings. Manual therapy will be performed within a tolerable range without provoking symptom exacerbation and will be administered every other day for 3 weeks (a total of 11 sessions).

Sponsors & Collaborators

• Longhua Hospital

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-04-01

Primary Completion

2025-12-31

Completion

2025-12-31

Countries

• China

Study Locations