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

NCT07752199 | Completed

• 2 other identifiers: TJX62023007ZYYZDKXK-2023059
• Study Type: interventional
• Target: 72
• Locations: 1 country
• Sites: 1

Brief 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:

• 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

Outcome Measures

Primary Outcomes (1)

• Change in Oswestry Disability Index (ODI) Score

  Baseline and Week 3 (end of intervention)

Secondary Outcomes (4)

• Change in Pain Intensity Measured by Visual Analog Scale (VAS)

  Baseline and Week 3 (end of intervention)

• Health-related quality of life (SF-12)

  Baseline and Week 3

• Change in Infrared Thermographic Temperature Parameters

  Baseline, Week 1, and Week 3

• Change in Serum Inflammatory Biomarkers (IL-6 and TNF-α)

  Baseline and Week 3

Study Arms (2)

Arm 1

EXPERIMENTAL

Manual Therapy + Neural Mobilization

Behavioral: Neural Mobilization; Behavioral: Manual Therapy

Arm 2

SHAM COMPARATOR

Manual Therapy + Sham Neural Mobilization

Behavioral: Sham Neural Mobilization; Behavioral: Manual Therapy

Interventions

Neural Mobilization BEHAVIORAL

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.

Arm 1

Sham Neural Mobilization BEHAVIORAL

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

Arm 2

Manual Therapy BEHAVIORAL

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).

Arm 1; Arm 2

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults aged 18-65 years. Diagnosis of lumbar disc herniation based on clinical symptoms and imaging findings.
• Presence of unilateral lumbar radiculopathy. Persistent symptoms despite initial conservative management. Ability to participate in the intervention protocol. Provided written informed consent before study enrollment.

You may not qualify if:

• Participants will be excluded if they meet any of the following criteria:
• Requirement for surgical intervention for lumbar disc herniation. Serious spinal conditions, including spinal infection, tumor, or fracture. Severe systemic diseases or acute inflammatory conditions. Pregnancy or breastfeeding. Receipt of other interventions that may affect study outcomes during the study period.

Sponsors & Collaborators

• Longhua Hospital: lead

Study Sites (1)

Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine

Shanghai, 200032, China

Location

Related Publications (3)

• Basson A, Olivier B, Ellis R, Coppieters M, Stewart A, Mudzi W. The Effectiveness of Neural Mobilization for Neuromusculoskeletal Conditions: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther. 2017 Sep;47(9):593-615. doi: 10.2519/jospt.2017.7117. Epub 2017 Jul 13.

  PMID: 28704626 RESULT

• Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996 Mar;34(3):220-33. doi: 10.1097/00005650-199603000-00003.

  PMID: 8628042 RESULT

• Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976). 2000 Nov 15;25(22):2940-52; discussion 2952. doi: 10.1097/00007632-200011150-00017.

  PMID: 11074683 RESULT

MeSH Terms

Conditions

Intervertebral Disc Displacement

Interventions

Musculoskeletal Manipulations

Condition Hierarchy (Ancestors)

Spinal Diseases; Bone Diseases; Musculoskeletal Diseases; Hernia; Pathological Conditions, Anatomical; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Complementary Therapies; Therapeutics; Physical Therapy Modalities; Rehabilitation

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Orthopedic Physical Therapist

Study Record Dates

• First Submitted: August 3, 2026
• First Posted: August 7, 2026
• Study Start: April 1, 2025
• Primary Completion: December 31, 2025
• Study Completion: December 31, 2025
• Last Updated: August 7, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)