Use of Progressive Neurodynamic Exercises in Conservative Treatment of Acute Lumbar Radiculopathy

Abstract

Background: Radiculopathy occurs when there is compression of the nerve at the level of the spinal nerve root. The clinical presentation of radiculopathy depends on the level of spinal compression but involves corresponding diminished reflex, impaired dermatomal sensation, and myotomal weakness. Current research supports conservative physical therapy management of acute low back pain with a symptom modulation approach including manual therapy, directional preference exercises, or traction. The objective of this case report is to explore the effectiveness of incorporating progressive neurodynamic exercises into physical therapy treatment of acute lumbar radiculopathy. Case Description: A 26-year-old female patient presents to an outpatient physical therapy clinic with complaints of right lower extremity weakness, numbness, and pain. Myotomal, dermatomal, and reflex testing revealed signs and symptoms consistent with L5-S1 lumbar radiculopathy. The patient was conservatively treated with progressive neurodynamic exercises in addition to traction and other manual therapy techniques. Patient saw significant improvements in lower extremity neurodynamics, pain, and function following 14 sessions of interventions. Discussion: Further research involving larger, randomized control trials are needed to explore whether utilizing progressive neurodynamic exercises should be more regularly incorporated into existing guidelines for conservative management of acute lumbar radiculopathy.