review · Journal of Clinical Medicine
Lumbar disc herniation associated with radiculopathy is a common spinal condition caused by nerve root irritation from a herniated disc. Non-surgical methods serve as the preferred primary management strategy to reduce pain and disability when red-flag complications are absent. A synthesis of recent clinical research evaluated the effectiveness of diverse conservative approaches to inform clinical decision-making. Moderate evidence supports interventions such as patient education, self-management, the McKenzie method, mobilisation and manipulation, exercise therapy, neural mobilisation, epidural injections, and traction for short-term outcomes. In contrast, dry needling and traction for long-term outcomes demonstrate weak evidence. Commonly used modalities, including electrotherapy, ultrasound, laser, and electro-diagnostic-based management, show conflicting or no evidence of therapeutic benefit.
Nerve irritation caused by lumbar disc herniation is a leading driver of spinal pain and physical disability. Identifying which non-surgical treatments are supported by solid clinical evidence helps therapists and patients choose interventions that genuinely relieve symptoms, avoiding reliance on ineffective therapies or premature surgical procedures.
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Lumbar disc herniation associated with radiculopathy (LDHR) is among the most frequent causes of spine-related disorders. This condition is triggered by irritation of the nerve root caused by a herniated disc. Many non-surgical and surgical approaches are available for managing this prevalent disorder. Non-surgical treatment approaches are considered the preferred initial management methods as they are proven to be efficient in reducing both pain and disability in the absence of any red flags. The methodology employed in this review involves an extensive exploration of recent clinical research, focusing on various non-surgical approaches for LDHR. By exploring the effectiveness and patient-related outcomes of various conservative approaches, including physical therapy modalities and alternative therapies, therapists gain valuable insights that can inform clinical decision-making, ultimately contributing to enhanced patient care and improved outcomes in the treatment of LDHR. The objective of this article is to introduce advanced and new treatment techniques, supplementing existing knowledge on various conservative treatments. It provides a comprehensive overview of the current therapeutic landscape, thereby suggesting pathways for future research to fill the gaps in knowledge. Specific to our detailed review, we identified the following interventions to yield moderate evidence (Level B) of effectiveness for the conservative treatment of LDHR: patient education and self-management, McKenzie method, mobilization and manipulation, exercise therapy, traction (short-term outcomes), neural mobilization, and epidural injections. Two interventions were identified to have weak evidence of effectiveness (Level C): traction for long-term outcomes and dry needling. Three interventions were identified to have conflicting or no evidence (Level D) of effectiveness: electro-diagnostic-based management, laser and ultrasound, and electrotherapy.
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DOI: 10.3390/jcm13040974
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