EFFECTIVENESS OF NEURAL MOBILIZATION VERSUS STRENGTHENING EXERCISES IN REDUCING PAIN AND DISABILITY IN PATIENTS WITH LUMBAR RADICULOPATHY

Background: Lumbar radiculopathy is a disabling condition commonly associated with radiating leg pain, sensory symptoms, and functional restriction. Conservative physiotherapy remains a preferred first-line approach, yet the comparative benefit of neural mobilization and strengthening exercises is still debated. Neural mobilization targets neural mobility and mechanosensitivity, whereas strengthening exercises improve lumbopelvic control and muscular support. Clear comparative evidence is needed to guide practical, patient-centered rehabilitation planning for individuals with lumbar radiculopathy in routine clinical settings more effectively. Objective: To compare the effectiveness of neural mobilization and strengthening exercises in reducing pain and disability among patients with lumbar radiculopathy. Methods: This single-center, parallel-group randomized controlled trial enrolled 44 adults with clinically and radiologically diagnosed lumbar radiculopathy. Participants were randomly allocated into Group A and Group B, with 22 participants in each group. Group A received neural mobilization using nerve sliding and tensioning techniques, while Group B received lumbar stabilization and strengthening exercises. Both groups completed 8 supervised sessions over 4 weeks. Pain was assessed by the Numeric Pain Rating Scale and disability by the Oswestry Disability Index. Wilcoxon signed-rank and Mann-Whitney U tests were applied using SPSS version 27. Results: Pain intensity improved significantly within both groups after intervention, including Group A receiving neural mobilization (Z = -4.165, p < 0.001) and Group B receiving strengthening exercises (Z = -3.810, p < 0.001). Group A showed significant improvement across all ODI domains (p < 0.05), while Group B showed significant improvement in most ODI domains (p < 0.05), except walking (p = 0.171) and standing (p = 0.172). Between-group analysis showed a significant post-intervention difference in NPRS, with Group A having a lower mean rank than Group B, indicating lower post-treatment pain in the neural mobilization group (mean rank: 16.86 vs. 28.14; Z = -3.104, p = 0.002). However, total post-intervention ODI scores did not differ significantly between groups (mean rank: 23.27 vs. 21.73; Z = -0.465, p = 0.642). Conclusion: Both interventions reduced pain and disability in lumbar radiculopathy. Strengthening exercises showed greater short-term pain relief, while disability outcomes remained comparable, supporting individualized physiotherapy planning. Keywords: Exercise Therapy; Low Back Pain; Neuralgia; Pain Measurement; Physical Therapy Modalities; Radiculopathy; Rehabilitation.