IMMEDIATE EFFECT OF SUSTAINED NATURAL APOPHYSEAL GLIDES (SNAGS) ON PROLAPSED INTERVERTEBRAL DISC (PIVD) IN PATIENTS WITH LOW BACK PAIN: A PRE-POST EXPERIMENTAL STUDY
DOI:
https://doi.org/10.71000/pcth9a98Keywords:
SNAGs, Prolapse Intervertebral Disc, Range of Motion, Spinal flexibility, Straight Leg Raise, Acute Low Back Pain, Manual TherapyAbstract
Background: Low back pain (LBP) is a leading musculoskeletal disorder globally, often resulting in functional disability and reduced quality of life. Among its etiologies, prolapsed intervertebral disc (PIVD) is a major contributor, frequently causing nerve compression and spinal mobility limitations. Manual therapy techniques such as Sustained Natural Apophyseal Glides (SNAGs), based on Mulligan’s concept, have shown potential in alleviating symptoms by enhancing joint mechanics and reducing pain.
Objective: To evaluate the immediate effect of SNAGs on pain, spinal flexibility, and straight leg raise (SLR) range in patients with PIVD.
Methods: This pretest-posttest experimental study recruited 28 participants (19 males, 9 females; mean age = 32.32 ± 8.14 years) through non-probability convenience sampling. Inclusion criteria were age 20–60 years, clinical diagnosis of PIVD, and a finger-to-floor distance >20 cm. Exclusion criteria included spinal surgery, fractures, neurological disorders, psychosis, and pregnancy. All participants received a single session of standardized SNAGs applied to the affected lumbar segment. Outcome measures included the Visual Analog Scale (VAS) for pain, SLR for neural mobility, and Finger-to-Floor (FTF) test for spinal flexibility. Data were analyzed using SPSS v26.0, with Shapiro-Wilk test assessing normality and paired t-tests determining statistical significance.
Results: Pain levels significantly reduced post-intervention (VAS pre: 7.53 ± 1.23; post: 3.81 ± 0.25; p = 0.002). SLR improved markedly in both limbs (Right pre: 65.89° ± 15.15; post: 81.25° ± 9.09; p = 0.000 | Left pre: 68.60° ± 16.74; post: 77.32° ± 11.74; p = 0.001). Spinal flexibility improved as FTF distance decreased (pre: 23.91 ± 4.76 cm; post: 18.03 ± 5.12 cm; p = 0.000). Strong correlations were observed between pre- and post-values (r = 0.630–0.897).
Conclusion: SNAGs produced immediate and significant improvements in spinal flexibility, lower limb mobility, and pain levels among PIVD patients, supporting their clinical utility in conservative LBP management.
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