Physiotherapy management of lumbar disc herniation with radiculopathy: A narrative review

Introduction: Lumbar disc herniation with radiculopathy (LDHR) has been one of the most difficult conditions to manage among low back disorders. Individuals with chronic or recurring lumbar radiculopathy experience difficulties returning to work due to poor lower limb neuromuscular control. Given the consequences of LDHR, there is the need for effective treatment approaches that will be helpful in the amelioration of the problem. Objectives: In this study the most recent physical therapy literature in the management of patients with LDHR was evaluated. Methods: A literature review was conducted from inception to January 2019 in the PubMed, PEDro, and OTseeker databases. Results: Fifteen studies relating to the physiotherapy managements of LDHR were identified and discussed. Out of these studies, 1 study was a cohort study and 14 studies were randomized controlled trials. 5 studies examined the effects of physical therapy modalities, 6 studes examined the effects of physical therapy/exercises and 4 studies examined the effects of spinal manipulation (SM) in the management of LDHR. Conclusion: The findings of this study concluded that extension-oriented treatment approach, SM and lumbar stabilization exercise in combination with low power laser therapy are better than any physiotherapy intervention in the management of LDHR.