Effectiveness Of Conventional Physical Therapy Treatment With Or Without Sciatic Nerve Mobilization In Patients With Sciatic Nerve Related Para Spinal Muscle Spasms

Abstract

Background: Sciatica is a persistent ailment that causes excruciating low back pain that radiates down to the posterior thigh, where the sciatic nerve is innervated. It continues to be a huge global public health issue with serious socioeconomic, physical, and psychological consequences. Between the lower 12th rib borders and the lower gluteal folds is where low back pain (LBP) is felt. With 37% of patients reporting at least monthly experiences or recurrent episodes of back pain, LBP is one of the major causes of disability globally. Similar findings were found in earlier surveys carried out in Malaysia, where the incidence of LBP was found to be about 12% in a semi-rural community and to be high at 60% and 68%, respectively, among commercial vehicle drivers and medical students (Zafarani & Almeheyawi, 2024). LBP patients may concurrently experience PS, or piriformis syndrome (PS). The frequency of PS ranges greatly from 0.3% to 36% (Arshad, Raza, Naseem, Waheed, & Rasheed, 2025).

Objective: To compare the efficacy of nerve mobilization and conventional physical therapy in patients with nerve related para spinal muscle spasm.

Rationale

Nerve related Para spinal muscle spasm is the most common health issue in today’s practice. There are many reasons for spasm. But in countries like Pakistan the socioeconomic conditions of people play a vital role to produce ailments like backache and other musculoskeletal disorders. In this study the main outcome is to give best way of treatment to the people which is cost effective and beneficial for health.

Methodology: It was a randomized control trial study. Data was collected from physiotherapy department, Nishter Hospital Multan, sample size was 124 patients which were selected through purposive random sampling.

Numeric pain rating scale (NPRS) was used to find out the frequency. Sample selection was computed through Cochran’s formula, and level of significance of 5%. (Vijayalakshmi, Lokesh, Kanthanathan, Aseer, & Ramachandran, 2022)

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The data was analyzed by SPSS 26.0 Version.

Results: Total 124 patients were allocated in two groups; named group A and group B according to inclusion and exclusion criterion. Then almost 6 patients were drop out from the study, in which two were drop out from the group A and four were drop out from the group B. Group A received straight leg raising technique along with the baseline conventional treatment for a time period of 6 times per week in total 6 sessions. Group B received slump stretching technique along with the conventional as same for the group A. NPRS was used for assessment of pain and modified Oswestry disability index was used for assessment of issues in daily activities caused by Low back pain. Study was completed within duration of 3 months. Data from both groups was gathered and the mean score for all the outcome measures was investigated.

Outcome of this trial reveals that both treatments are positive in improving pain and reducing spasm of para spinal muscle caused by sciatic nerve; but sciatic nerve mobilization showed more improvement as compared to simple conventional physical therapy treatment along with straight leg raise. Many clinical trials have been escorted by different researchers to investigate the effects of sciatica nerve mobilization and straight leg raise on para spinal muscle spasm caused by sciatic nerve. The majority of the studies supported the use of sciatic nerve mobilization on the para spinal muscle spam and pain related to sciatica nerve entrapment.

Conclusion: This randomized controlled trial evaluated the effects of conventional physical therapy with or without sciatic nerve mobilization on para spinal muscle spasm caused by sciatica. A total of 124 patients were divided into two groups (A and B) with 6 dropouts during the study. Group A received straight leg raise exercises with conventional therapy, while group B received slum stretching along with the same therapy. Pain and disability were assessed using NPRS and the modified Oswestry Disability Index over a three-month period. Both groups showed improvement, but group B demonstrated greater reduction in pain and spasm, aligning with previous research favoring nerve mobilization.