Clinical Research Directory

Effects of Adding Balneotherapy to a Physical Therapy Program in Patients With Chronic Lumbar Radiculopathy

The aim of this study is to investigate the effects of adding balneotherapy to the conventional physical therapy program on neuropathic pain, disability, daily living activities, and sleep quality in patients with chronic lumbar radiculopathy.

Comparative Effects of Kinetic Control Training and Neural Mobilization in Lumbar Radiculopathy

Radiculopathy is a neuromusculoskeletal disorder characterized by compression or irritation of a spinal nerve root, resulting in pain, reduced range of motion, sensory disturbances, muscle weakness, and functional disability. It commonly affects the cervical and lumbar regions and can significantly impair daily activities and quality of life. Various physiotherapy interventions have been used to manage radiculopathy, including exercise therapy, manual therapy, neural mobilization, and motor control training. However, the most effective intervention for improving pain, mobility, and functional outcomes remains unclear, highlighting the need for further research. Kinetic Control (KC) Training focus on identifying and correcting faulty movement patterns through motor control retraining and postural correction, thereby reducing mechanical stress on the affected structures. Neural Mobilization (NM) aims to restore the normal mobility and physiological function of neural tissues, decrease neural mechanosensitivity, and improve nerve movement within surrounding tissues. The objective of this study is to compare the effects of Kinetic Control techniques and Neural Mobilization on pain, range of motion, and disability among patients with radiculopathy. The study will be conducted as a randomized clinical trial. Participants will be recruited using non-probability convenience sampling and will be randomly allocated into two groups. Group A will receive Kinetic Control s, while Group B will receive Neural Mobilization. Both groups will receive conventional physiotherapy treatment, including hot pack, TENS application for 20 minutes before intervention. The treatment protocol will consist of 12 sessions over a period of 4 weeks. Outcome measures will be assessed at baseline, the 2nd week, and the 4th week. Pain intensity will be measured using the Numeric pain rating scale (NPRS), range of motion will be assessed using Bubble Inclinometer, and disability will be evaluated using the Revised Oswestry Disability Index (RODI) for lumbar radiculopathy. Data will be analyzed using SPSS version 24. The findings of this study may provide evidence regarding the comparative effectiveness of Kinetic Control training and Neural Mobilization technique in improving clinical outcomes among patients with radiculopathy.

Effect of Transfer of Energy Capacitive and Resistive on Chronic Discogenic Sciatica

The goal of this clinical trial is to evaluate the effect of Transfer of Energy Capacitive and Resistive (TECAR) on pain, functional disability and electrophysiological parameters in adults with chronic discogenic sciatica . The main questions it aims to answer are: • Is there significant effect of TECAR therapy on pain, functional disability and Electrophysiological parameters (H-reflex latency and amplitude) ? Researchers will compare effect of adding TECAR therapy to conventional physical therapy program (TENS, hot pack, stretching exercises and core stability exercises) Vs conventional physical therapy program alone to see if there is a beneficial effect of adding TECAR therapy to physical therapy program Participants in study group will receive TECAR therapy in addition to conventional PT program while participants in control group will receive conventional PT program

Selective Nerve Root Block Versus Sham to Reduce Surgery for Lumbar Disc Herniation

The SELDISC trial will investigate whether a selective nerve root block can reduce the need for surgery in adults with a herniated disc in the lower back. A herniated disc can irritate a nerve and cause pain that travels down the leg. A nerve root block delivers a local anaesthetic and a corticosteroid near the affected nerve to relieve pain and inflammation. The study will include 262 adults aged 18-66 years who have persistent leg symptoms despite non-surgical treatment and have been assessed by a spine surgeon as eligible for surgery. Participants will be randomly assigned to receive either a selective nerve root block or a sham procedure that mimics the treatment without delivering the active medication near the nerve. Each participant will have an equal chance of receiving either procedure. Participants and the study staff assessing their outcomes will not know which procedure was given. The radiologist performing the procedure will know the allocation. The main question is whether fewer participants in the nerve root block group undergo surgery within 12 months after randomisation. The study will also compare pain, disability, quality of life, time to surgery, medication use, sick leave, healthcare use and adverse events between the groups.

Comparative Effect Between Mulligan Leg Raise and Spinal Mobilization With Limb Movement in Lumbar Radiculopathy

This study examines the comparative effects of mulligan leg raise traction and Spinal Mobilization with Leg Movement (SMWLM) on lumbar radiculopathy

Tecar Therapy in Patients With Lumbar Radiculopathy

Lumbar radiculopathy is a common cause of low back and leg pain, most frequently resulting from lumbar disc herniation and nerve root irritation. Conservative management, including physical therapy modalities and exercise therapy, is generally recommended as first-line treatment for patients without progressive neurological deficits. Tecar therapy (Transfer of Energy Capacitive and Resistive) is a non-invasive electrotherapeutic modality that delivers high-frequency electromagnetic energy to deep tissues and has been proposed to reduce pain, enhance microcirculation, and promote tissue recovery. However, evidence regarding its effectiveness in lumbar radiculopathy remains limited. The aim of this randomized controlled trial is to evaluate the efficacy of Tecar therapy in patients with lumbar radiculopathy and to compare its clinical effects with conventional physical therapy and sham Tecar treatment. A total of 90 participants with unilateral L5 and/or S1 radiculopathy will be randomized into three groups: (1) conventional physical therapy, (2) Tecar therapy combined with standard physical therapy, and (3) sham Tecar therapy combined with standard physical therapy. All participants will receive standardized postural education and a home exercise program. The primary outcome will be pain intensity measured by the Visual Analog Scale (VAS). Secondary outcomes will include functional disability (Oswestry Disability Index), neuropathic pain characteristics (PainDETECT questionnaire), lumbar mobility (Modified-Modified Schober Test), nerve root irritability (Straight Leg Raise test), rescue analgesic consumption, and exercise adherence. Outcomes will be assessed at baseline, post-treatment (week 2), and follow-up visits at weeks 6 and 12.

Randomized Evaluation of Lumbar Injection Effectiveness and Function

The goal of this clinical trial is to learn whether the Triojection® System is safe and effective for treating symptomatic lumbar radiculopathy (leg pain caused by nerve irritation or compression) resulting from a contained herniated lumbar disc. The study will enroll adults 18 to 75 years of age with a single-level contained lumbar disc herniation who continue to have symptoms despite at least 6 weeks of non-surgical treatment and a previous lumbar spine injection. The main questions it aims to answer are: * Does treatment with the Triojection® System improve leg pain and overall clinical outcomes compared with Selective Nerve Root Block (SNRB) alone? * Is treatment with the Triojection® System safe, as measured by the absence of device- or procedure-related serious adverse events and persistent neurological deficits? Researchers will compare participants who receive Triojection® followed by SNRB with participants who receive SNRB alone to determine whether the investigational treatment provides improved clinical outcomes. Participants will: * Be randomly assigned to receive either Triojection® plus SNRB or SNRB alone. * Complete questionnaires about leg pain, back pain, disability, quality of life, sleep, anxiety, depression, and overall improvement. * Undergo physical and neurological examinations during study follow-up visits. * Have MRI scans performed at selected study visits to evaluate changes in the treated disc. * Attend follow-up visits at 1, 3, 6, 12, 18, and 24 months after treatment. Up to 300 participants will be enrolled at up to 30 investigational sites in the United States and Canada and followed for approximately 24 months after treatment.

Effectiveness and Safety of Pharmacopuncture Therapy for Chronic Lumbar Radiculopathy: A Multicenter, Pragmatic, Randomized, Comparative Clinical Trial

A pragmatic clinical study to compare the effectiveness of pharmacopuncture and physical therapy strategies in patients with chronic lumbar radiculopathy

Effect of Trans-spinal Electromagnetic Neuromodulation in Treatment of Patients With Discogenic Lumbosacral Radiculopathy

Purposes of the study To investigate the effect of adding Trans-spinal Electromagnetic Neuromodulation to conventional physical therapy in patients with Discogenic Lumbosacral Radiculopathy

Femoral Stretch Test in L2-L4 Lumbar Radiculopathy

This prospective observational study aims to evaluate the sensitivity of the femoral stretch test in patients with unilateral, single-root L2, L3, or L4 nerve root compression and to determine whether test positivity differs according to the affected nerve root. Patients with unilateral radicular symptoms and magnetic resonance imaging-confirmed single-root compression involving the L2, L3, or L4 nerve root who are scheduled to undergo transforaminal epidural steroid injection as part of routine clinical care will be included. The decision to perform transforaminal epidural steroid injection will be made independently of participation in the study. Before the procedure, the femoral stretch test, pain intensity, neuropathic pain characteristics, dermatomal concordance of symptoms, and relevant magnetic resonance imaging findings will be recorded. The femoral stretch test and pain intensity will be reassessed 1 hour after the procedure. The study will primarily evaluate the sensitivity of the femoral stretch test for L2, L3, and L4 nerve root involvement and will also assess changes in test findings following transforaminal epidural steroid injection.

Comparative Effects Between ELDOA and Spinal Mobilization With Limb Movement in Lumbar Radiculopathy

This study examines the comparative effects of ELDOA and Spinal Mobilization with Leg Movement (SMWLM) on lumbar radiculopathy

The Effect of Needle Insertion Angle on Contrast Distribution and Treatment Outcomes in S1 Transforaminal Epidural Steroid Injections

Nerve compression due to lumbar disc herniation (lumbosacral radiculopathy) is a condition characterized by pain in the lower back and legs and restricted lumbar joint movement due to the compression of nerves emerging from the lumbar spine caused by the protrusion of the intervertebral disc. Back pain negatively impacts patients' quality of life and emotional well-being. Treatment approaches aim to alleviate pain, improve joint mobility, and restore functionality through the use of pain-relief medications (topical or oral), physical therapy methods, and rehabilitation programs that include exercises for range of motion, stretching, and strengthening. When these approaches prove insufficient, interventional procedures (injection therapy) or surgical interventions come to the forefront. One of the proven interventional treatment methods for herniated disc disease is the transforaminal epidural steroid injection (TFESE), which involves the injection of cortisone around the compressed nerve due to the herniation and is frequently performed in our clinic. Transforaminal injections require imaging guidance and the use of contrast media to enhance the safety and effectiveness of the procedure. To visualize the S1 foramen, needle entry is performed using various angles under fluoroscopy guidance. This study will investigate the effect of the needle entry angle on the spread and pattern of contrast media, complications, and treatment outcomes in fluoroscopy-guided S1 transforaminal epidural steroid injections. The research aims to determine whether the needle entry angle influences the pattern of contrast spread and the treatment outcomes in S1 TFESE. Based on the findings of this study, the goal is to refine the procedure for patients requiring injections at this level in the future, optimizing the technique and clinical outcomes. This will provide essential insights to practitioners, maximize the benefits for the patient group undergoing the procedure, and make a significant contribution to medical science. Detailed information regarding the planned injection therapy by your algology specialist will be provided, and written and verbal consent will be obtained through the "Epidural Steroid Injection Consent Form." Various scales and questionnaires will be administered at specific intervals-prior to the procedure, 1 hour after, 3 weeks after, and 3 months after-to evaluate pain levels, treatment response, and the impact on daily activities. The content of these evaluations will be explained in detail by your physician. Temporary side effects related to the injection may include increased pain at the injection site, low blood pressure, dizziness, fainting, and allergic reactions, all of which can be managed with appropriate treatment. Although rare, severe side effects such as nerve damage, spinal cord injury, or stroke have been reported in some cases. However, adherence to the guidelines outlined in treatment protocols and the performance of the procedure by adequately trained and experienced physicians significantly reduce the likelihood of these serious side effects. This injection will be performed by an algology specialist with at least 10 years of experience in this field. All necessary precautions will be taken against potential side effects, and the performing team will provide immediate medical intervention in case of complications. Approximately 66 volunteers will participate in this study, with each follow-up evaluation expected to take about 15 minutes. The identities of participants will remain confidential, and they have the right to withdraw from the study at any time by notifying the researchers. If deemed necessary by the researchers, participants may also be excluded from the study. If a participant declines to participate or is excluded from the study, their treatment will not be interrupted. Participants will not bear any financial responsibility for research-related expenses, and no additional travel costs will be incurred as evaluations will coincide with regular clinic visits.

Three-dimensional Lumbar Myofascial Release and Motor Control in Lumbar Radiculopathy

to investigate The Efficacy of three-dimensional lumbar myofascial release with motor control training on back perception and pain in lumbar radiculopathy Patients with lumbar radiculopathy demonstrate impairments in function and range of motion to deficits in patient's quality of life.

Determination of Sensitivity and Specificity of Straight Leg Raise Test Via Transforaminal Nerve Root Block

This study aims to evaluate the diagnostic accuracy of the straight leg raise test in patients with suspected lumbosacral radicular pain. Lumbosacral radicular pain is often caused by lumbar disc herniation and may radiate from the lower back or buttock to the leg. Although the straight leg raise test is commonly used in clinical practice, its diagnostic performance has been reported to vary. In this study, diagnostic transforaminal epidural steroid injection or selective nerve root block will be used as the reference standard. The sensitivity, specificity, likelihood ratios, and area under the curve of the straight leg raise test will be calculated. The findings may help guide clinicians in determining when the straight leg raise test is sufficient and when further diagnostic confirmation may be needed.

High-power Laser Versus Pulsed Electromagnetic Therapy in Lumbar Radiculopathy.

To compare between high-power laser versus pulsed electromagnetic therapy on pain and Hoffman reflex in lumbar radiculopathy.

Comparing of Using Patient Imaging and Virtual Reality-based Simulation Prior to Lumbar Transforaminal Injections

This study aims to evaluate the impact of pre-procedure training using a 3D simulator, based on lumbar CT images, on the success rate and efficiency of lumbar transforaminal steroid injections in patients who are expected to be difficult to treat. The training is provided to practitioners prior to performing the procedure on these patients.

Dose Dependent Steroid Injections

This study aims to evaluate the efficacy of interlaminar steroid injections at treating pain in lumbar radiculopathy at varying doses, to evaluate the efficacy of interlaminar steroid injections at improving quality of life and function in lumbar radiculopathy at varying doses, and to evaluate difference in efficacy between triamcinolone and dexamethasone interlaminar steroid injections at treating pain in lumbar radiculopathy at varying doses, with the overarching hypotheses that there is no difference in reported pain reduction, quality of life, or function among patients receiving low, moderate, or high doses, and no difference in reported pain reduction between triamcinolone and dexamethasone.

Comparative Effects of Mulligan Bent Leg Raise Versus Spinal Mobilization With Leg Movement in Lumbar Radiculopathy

Lumbar radiculopathy is a spinal nerve root disorder often caused by lumbar disc herniation or compression, leading to radiating leg pain, restricted movement, and functional difficulties. This condition significantly disrupts daily activities and overall quality of life. While medication and exercise are common treatments, manual therapy techniques are gaining recognition for their non-invasive and effective outcomes in relieving symptoms and improving patient function.

Effects of Shockwave Therapy Versus Ultrasound Therapy Among Patients With Chronic Sciatica

Sciatica is characterized by radiating pain, functional limitations, reduced flexibility, disturbed sleep, and impaired quality of life. Extracorporeal Shockwave Therapy (ESWT) and Therapeutic Ultrasound are commonly used physiotherapy modalities for pain relief and tissue healing; however, evidence directly comparing their effectiveness remains limited. This randomized controlled trial compares the effects of Shockwave Therapy and Ultrasound Therapy, each combined with conventional physiotherapy, on pain intensity, hamstring range of motion, sleep quality, and quality of life in patients with chronic sciatica.

High-Intensity Laser Therapy Versus Transforaminal Epidural Steroid Injection in Chronic Lumbar Disc Herniation-Related Low Back and Radicular Pain

This prospective, randomized, single-blinded, controlled clinical trial aims to compare the effectiveness of high-intensity laser therapy and fluoroscopy-guided transforaminal epidural steroid injection in patients with chronic low back pain and lumbar radiculopathy. Eligible patients will be randomized into two parallel groups. One group will receive high-intensity laser therapy, and the other group will receive transforaminal epidural steroid injection. All participants will also receive a standardized home-based exercise program. Outcomes will be assessed at baseline, 2 weeks, 6 weeks, and 12 weeks after treatment. The primary outcome will be pain intensity measured by the Visual Analog Scale. Secondary outcomes will include functional disability, neuropathic pain symptoms, quality of life, and functional walking capacity.

Effects of Spinal Mobilization With Leg Movement With and Without Neural Flossing Technique in Lumbar Radiculopathy

Lumbar radiculopathy is a spinal condition caused by compression or irritation of the lumbar nerve roots, leading to radiating leg pain, sensory changes, and functional disability. It commonly affects middle-aged and older adults, impairing daily activities and quality of life. Conservative treatments include medication, physiotherapy, and exercise. Spinal Mobilization with Leg Movement (SMWLM), a Mulligan technique, uses passive vertebral mobilization with active leg motion to reduce nerve compression and improve mobility. Neural flossing, or neurodynamic mobilization, enhances nerve mobility by promoting gliding of nerve roots, especially in cases of restricted neural movement. This study aims to evaluate the effects of spinal mobilization with leg movement (SMWLM) with and without neural flossing technique on pain, disability, and range of motion in patients with lumbar radiculopathy.

Comparative Effects of Spinal Mobilization With Leg Movement, and Mechanical Traction in Lumbar Spine Radiculopathy.

Recruitment: Individuals with the lumbar spine radiculopathy diagnosis will undergo screening to determine their eligibility based on inclusion and exclusion criteria. Eligible participants will be asked for their informed consent. Enrollment: Participants will receive a unique identifying code to maintain confidentiality and be formally enrolled in the study upon obtaining informed consent. Following that, they will have baseline evaluations for outcome factors such as numeric pain rating scale, Oswestry disability index, and modified-modified Schober test. After completing the baseline evaluation, participants will be divided into two groups: Group A will receive the Mulligan's spinal mobilization with leg movement, while Group B will receive mechanical lumbar traction. Every participant will get treatment for four weeks, with three sessions per week. At the conclusion of the intervention period, a post-intervention assessment will be carried out.

Comparison of Clinical Effectiveness of Full Endoscopic Lumbar Discectomy (FELD) and Microdiscectomy (MD) in Patients With Lumbar Disc Herniation

The goal of this clinical trial is to compare the clinical effectiveness of Full Endoscopic Lumbar Discectomy (FELD) and Microdiscectomy (MD) in patients aged 18-85 with single-level lumbar disc herniation who have not undergone prior lumbar surgery. This study also aims to perform a radiological analysis of MRI scans before and after treatment to optimize patient selection and surgical strategies. The main questions it aims to answer are: * Does FELD provide superior early postoperative pain relief (measured by VAS) compared to MD? * Does FELD offer better functional recovery (measured by COMI and ODI scores) postoperatively compared to MD? * Can radiological analysis of pre- and post-operative MRI images help optimize patient qualification and guide surgical strategies? Researchers will compare patients undergoing FELD to those undergoing MD to see if endoscopic techniques result in faster recovery and lower early postoperative pain while maintaining similar long-term outcomes. The study will also analyze how MRI findings correlate with clinical outcomes to refine operative decision-making. Participants will: * Undergo either FELD or MD surgery * Complete VAS, COMI, and ODI questionnaires at pre-specified follow-up intervals (1, 3, 6, and 12 months post-surgery) * Have MRI scans 24 hours before surgery, 24 hours after surgery, and at each follow-up to assess disc recurrence, residual pathology, and to optimize surgical strategies.

Effects of Myokinetic Stretching Technique With And Without Neural Flossing Technique In Lumbar Radiculopathy

This single-blinded randomized clinical trial aims to evaluate the comparative effects of Myokinetic Stretching Technique (MST) alone versus MST combined with Neural Flossing Technique (NFT) in individuals with lumbar radiculopathy. A total of 22 participants aged 25-55 will be recruited through non-probability convenience sampling from rehabilitation clinics in Lahore and randomly assigned to two intervention groups