EFFECTS OF MYOFASCIAL RELEASE AND NERVE FLOSSING TECHNIQUE ON PAIN AND DISABILITY IN PATIENTS WITH LUMBAR RADICULOPATHY
DOI:
https://doi.org/10.71000/gvqgry38Keywords:
sciatica , Disability Evaluation, , Low Back Pain, Lumbar Vertebrae, Myofascial Pain Syndromes, Nerve Compression Syndromes, Physical Therapy ModalitiesAbstract
Background: Lumbosacral radiculopathy is a prevalent neuromuscular disorder resulting from compression or irritation of lumbosacral nerve roots (L1–S4), commonly presenting with lower back pain radiating to the hip, thigh, and leg. Symptoms may include tingling, numbness, paresthesia, and shooting pain. It significantly impacts daily functioning and quality of life. Manual therapy interventions such as myofascial release (MFR) and nerve flossing technique (NFT) have gained attention for their therapeutic potential in managing radicular symptoms and improving functional outcomes.
Objective: To determine the effects of myofascial release and nerve flossing technique on pain and disability in patients with lumbar radiculopathy.
Methods: This randomized controlled trial included 36 participants aged 20–45 years diagnosed with lumbar radiculopathy, selected through non-probability convenience sampling. Participants were randomly assigned into two groups via the lottery method. Group A received a combination of MFR and NFT along with conventional physiotherapy, while Group B received NFT with conventional treatment alone. Interventions were administered three times per week for four weeks. MFR was applied for 10 minutes per session, and NFT consisted of 2 sets of 10 repetitions over 15 minutes. Outcomes were assessed using the Numeric Pain Rating Scale (NPRS) and the Oswestry Disability Index (ODI) at baseline and after four weeks. Data were analyzed using SPSS v23.
Results: Group A showed a reduction in NPRS from 7.16 ± 1.46 to 1.33 ± 0.90 and in ODI from 24.83 ± 8.21 to 4.55 ± 1.72. Group B showed a reduction in NPRS from 7.00 ± 1.41 to 2.72 ± 0.95 and in ODI from 25.44 ± 9.46 to 7.22 ± 2.31. Inter-group comparisons showed statistically significant differences in post-intervention scores (p < 0.05).
Conclusion: The combination of myofascial release and nerve flossing was more effective in reducing pain and disability compared to nerve flossing alone, suggesting a synergistic benefit in treating lumbar radiculopathy.
References
Zainab SA, Avaid A, Fatimah W, Perveen W, Naseem N. Effects of Sciatic Nerve Mobilization on Pain, Disability and Range in Patients with Lumbar Radicular Pain. Pakistan Journal of Medical & Health Sciences. 2022;16(10):97-.
Rajan AP, Gurudut P. Gross myofascial release of trunk with leg pull technique on low back pain with radiculopathy—A randomised controlled trial. Hong Kong Physiotherapy Journal. 2023;43(01):61-71.
Peacock M, Douglas S, Nair P. Neural mobilization in low back and radicular pain: a systematic review. Journal of Manual & Manipulative Therapy. 2023;31(1):4-12.
GHANIMA BA, MANSOUR WT, ELSISI YB, ELBALAWY YM. Effect of Mulligan Bent Leg Raise Technique on Patients with Discogenic Sciatica.
Farooq M, Bashir MS, Arif A, Kashif M, Manzoor N, Abid F. Effects of elongation longitudinaux avec decoaption osteo-articulaire and post-facilitation stretching technique on pain and functional disability in mobile users with text neck syndrome during COVID-19 pandemic: A randomized controlled trial. Medicine. 2023;102(12).
Krishna H, Pk S, Dhote C. Comparison between immediate effect of neural mobilization and myofascial release of suboccipital muscle on hamstring length in younger adults—an interventional study. Int J Sci Healthc Res. 2021; 6:438-45.
Seo U-H, Kim J-H, Lee B-H, editors. Effects of Mulligan mobilization and low-level laser therapy on physical disability, pain, and range of motion in patients with chronic low back pain: a pilot randomized controlled trial. Healthcare; 2020: MDPI.
Ergezen G, Sahin M. Comparison of self-myofascial release and stretching exercises in individuals with piriformis syndrome: a randomised controlled trial. International Journal of Therapy and Rehabilitation. 2023;30(11):1-10.
Elsayyad MM, Abdel-Aal NM, Helal ME. Effect of adding neural mobilization versus myofascial release to stabilization exercises after lumbar spine fusion: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation. 2021;102(2):251-60.
Alfawaz S, Lohman E, Alameri M, Daher N, Jaber H. Effect of adding stretching to standardized procedures on cervical range of motion, pain, and disability in patients with non-specific mechanical neck pain: A randomized clinical trial. Journal of Bodywork and Movement Therapies. 2020;24(3):50-8.
Yallappa M. A comparative study on effect of iliotibial band myofascial release on functional disability in patients with knee osteoarthritis. 2020.
Pradeep S, Heggannavar A, Metgud S. Effect of sciatic nerve neurodynamic sustained natural apophyseal glides on individuals with pelvic crossed syndrome: A randomized controlled trial. Indian Journal of Physical Therapy and Research. 2020;2(1):35-40.
Kuris EO, McDonald CL, Palumbo MA, Daniels AH. Evaluation and Management of Cauda Equina Syndrome. Am J Med. 2021;134(12):1483-9.
Hincapié CA, Kroismayr D, Hofstetter L, Kurmann A, Cancelliere C, Raja Rampersaud Y, et al. Incidence of and risk factors for lumbar disc herniation with radiculopathy in adults: a systematic review. Eur Spine J. 2025;34(1):263-94.
Cosamalón-Gan I, Cosamalón-Gan T, Mattos-Piaggio G, Villar-Suárez V, García-Cosamalón J, Vega-Álvarez JA. Inflammation in the intervertebral disc herniation. Neurocirugia (Engl Ed). 2021;32(1):21-35.
Zhang AS, Xu A, Ansari K, Hardacker K, Anderson G, Alsoof D, et al. Lumbar Disc Herniation: Diagnosis and Management. Am J Med. 2023;136(7):645-51.
Randhawa S, Garvin G, Roth M, Wozniak A, Miller T. Maigne Syndrome - A potentially treatable yet underdiagnosed cause of low back pain: A review. J Back Musculoskelet Rehabil. 2022;35(1):153-9.
Bateman EA, Fortin CD, Guo M. Musculoskeletal mimics of lumbosacral radiculopathy. Muscle Nerve. 2025;71(5):816-32.
Ghasabmahaleh SH, Rezasoltani Z, Dadarkhah A, Hamidipanah S, Mofrad RK, Najafi S. Spinal Manipulation for Subacute and Chronic Lumbar Radiculopathy: A Randomized Controlled Trial. Am J Med. 2021;134(1):135-41.
Rashed S, Vassiliou A, Starup-Hansen J, Tsang K. Systematic review and meta-analysis of predictive factors for spontaneous regression in lumbar disc herniation. J Neurosurg Spine. 2023;39(4):471-8.
Danazumi MS, Bello B, Yakasai AM, Kaka B. Two manual therapy techniques for management of lumbar radiculopathy: a randomized clinical trial. J Osteopath Med. 2021;121(4):391-400.
González Espinosa de Los Monteros FJ, Gonzalez-Medina G, Ardila EMG, Mansilla JR, Expósito JP, Ruiz PO. Use of Neurodynamic or Orthopedic Tension Tests for the Diagnosis of Lumbar and Lumbosacral Radiculopathies: Study of the Diagnostic Validity. Int J Environ Res Public Health. 2020;17(19).
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Copyright (c) 2025 Muhammad Aqeel, Iqra Nisar, Syeda Hamna Bukhari, Syeda Serine Fatima, Nimra Mustafa, Jasrah noor, Aqsa Majeed, Azka Laraib (Author)
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