The American Journal of Medicine January 2021; Vol. 134; No. 1; pp. 135−141

Seyedezahra Hosseini Ghasabmahaleh, MD, Zahra Rezasoltani, MD, Afsaneh Dadarkhah, MSc, Sanaz Hamidipanah, MD, Reza Kazempour Mofrad, Sharif Najafi, MD: This study cites 22 references.

Lumbar radiculopathy, affecting 3%-5% of the general population, presents a formidable challenge in the realm of musculoskeletal disorders. This study delves into the effectiveness of spinal manipulation as a therapeutic intervention for subacute and/or chronic lumbar radiculopathy, offering a beacon of hope for those grappling with persistent pain and disability.

1. The Landscape of Lumbar Radiculopathy

  • Lumbar radiculopathy, often accompanied by neurological manifestations, arises from compressive forces on specific nerve routes.
  • The force can emanate from various sources, such as disc herniation, hypertrophied facets, spondylolisthesis, neoplastic diseases, or infectious processes.
  • A significant proportion of lumbar radiculopathies endure for more than four weeks, necessitating nonoperative treatments before considering surgical intervention.

2. Safety and Desirability of Spinal Manipulation

  • Spinal manipulation emerges as a safe and desirable option for conservative treatment, especially when compared to medical alternatives.
  • Previous studies highlight the positive impact of spinal manipulation on pain, the straight leg raise test, range of motion, disc herniation size, and neurological symptoms in lumbar radiculopathy.

3. Outcomes: Unveiling Success with Spinal Manipulation

  • This study, focusing on 44 patients aged 25 to 60 with unilateral radicular low back pain lasting more than four weeks, reveals promising outcomes.
  • The manipulation group, receiving both manipulation and physiotherapy, showcased significant reductions in pain and disability compared to the physiotherapy-only control group.
  • Notably, the manipulation group sustained favorable outcomes in pain control, disability reduction, range of motion improvement, and the straight leg raise test.

4. Mechanisms Behind Spinal Manipulation

  • Spinal manipulation’s success is attributed to promoting joint separation, enhancing joint gliding, and increasing joint gapping.
  • Pain reduction occurs through cytokine release, mechanoreceptor stimulation, and improved blood flow.

5. Clinical Significance and Future Directions

  • The clinical significance of this study lies in the assertion that spinal manipulation is effective in pain control and disability reduction for patients with subacute or chronic lumbar radiculopathy.
  • These benefits endure for at least three months, showcasing the long-lasting impact of spinal manipulation.
  • With minimal side effects, ease of administration, and high patient satisfaction, spinal manipulation emerges as a valuable therapeutic measure.

6. Recommendations and Conclusions

  • Combining manipulation with other treatments is proposed for patients with nonacute lumbar radiculopathy.
  • The study concludes that spinal manipulation improves the results of physiotherapy, highlighting its efficacy in managing lumbar radiculopathy.

In essence, this research paints a promising picture for individuals grappling with lumbar radiculopathy. Spinal manipulation, coupled with physiotherapy, emerges as a powerful intervention, offering relief from pain, reducing disability, and enhancing overall quality of life for those navigating the complexities of subacute or chronic lumbar radiculopathy.