NCT07444125

Two-leg Rotation and Sciatica

Effect of Adding Two Leg-rotation to Standard Physical Therapy in the Treatment of Sciatica Secondary to Lumbar Discogenic Lesions.

• Status: Not Yet Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 70 (estimated)
• Sponsor: University of Hail · Academic / Other
• Sex: All
• Age: 18 Years – 50 Years
• Healthy volunteers: Not accepted

Summary

this study including the application of a specific technique of Mulligan mobilization calles 2 leg rotation on patients having lumbar discogenic lesion with sciatica. this technique is designed to address sciatic pain and proposed to reduce sciatica by opening the intervertebral foramnia. However, there is no systematic evedince supporting its clinical effect

Detailed description

Among the different causes of low back pain (LBP) is a lesion in the lumbar discs. Narrowing of the disc space and intervertebral foramina, deterioration of disc quality, and protrusion outside its anatomical perimeters can lead to pressure on the surrounding structures and cause radicular pain (Ostelo, 2020). Radicular pain that follows the course of the sciatic nerve or part of it is referred to as sciatica. Sciatica can be so bothersome secondary to the pain experienced that it can also lead to sensory deficits, tightness in the hamstrings, and limit the person's ability to stand and walk normally, thereby reducing functional ability (Fairag et al., 2022). Emotional disturbances-such as anxiety about moving and depression of varying severity-often occur, especially in people who avoid activities that worsen their pain (Oosterhuis et al., 2019). Sciatica can be evaluated through several methods. Pain severity is often quantified using instruments such as the visual analog scale (VAS), the numeric pain rating scale (NPRS), and the McGill Pain Questionnaire (Ramasamy et al., 2017). Sciatic nerve mobility is commonly assessed by the straight leg raise (SLR) test, which measures the hip flexion angle (H. M. Hussein et al., 2024). Meanwhile, functional questionnaires determine how sciatic pain affects everyday activities (Machado et al., 2016). Several therapeutic options are available for treating sciatica and its associated symptoms, including surgical treatment (Machado et al., 2016), medications, physical therapy (Ostelo, 2020), and manual therapies (Kuligowski et al., 2021). Recent studies have highlighted the efficacy of manual therapy in the rehabilitation of subjects with sciatica (Clar et al., 2014). One such manual therapy is the Mulligan Concept, a relatively recent approach developed by pioneer manual therapist Brian Mulligan. Specific Mulligan techniques, such as two-leg rotation, have been described for treating sciatic pain (W Hing et al., 2020). It has been proposed that the two-leg rotation can enhance vertebral rotation and open the intervertebral foramina, thereby assisting in relieving compressions on the nerve roots caused by prolapsed discs (Pourahmadi et al., 2018). While the founder of the technique and his fellow students proposed theoretical effects of the two-leg rotation technique, the literature contains almost no research supporting its clinical usefulness. A recent meta-analysis investigated the commonly used Mulligan techniques in the treatment of sciatica and did not include any randomized trials on the two-leg rotation technique. High-quality research studies are needed to establish the clinical effectiveness of two-leg rotation techniques. These studies can help clinical practitioners and manual therapists to determine the appropriate use and expected results of applying the two-leg rotation technique (H. Hussein et al., 2025). This study aims to investigate the effect of adding a two-leg rotation technique to standard physical therapy on pain, flexibility, function, and sciatica-related bother in patients with discogenic low back pain.

Conditions

• Sciatica Due to Intervertebral Disc Disorder

Interventions

Type	Name	Description
OTHER	standard physical therapy	Modalities (TENS, US, and superficial heat) All participants received conventional TENS (Chattanooga, Intellect Advanced, USA) with the following parameters: frequency, 100 Hz; pulse duration, 60 ms; amplitude-modulated frequency, 10%; and intensity adjusted to a comfortable tingling sensation. Two electrodes (single channel) were used: the first was placed over the ipsilateral lumbar region, and the second over the popliteal fossa. The duration of the TENS was 20 minutes (Ozen et al., 2023). A ten-minute continuous Ultrasound (US) model (Chattanooga, Intellect Advanced, USA) was applied over the nerve roots. The 5 cm² US head was used, with a frequency of 1 MHz and an intensity of 1.5 W/cm² (Ozen et al., 2023). Exercises in the form of pelvic rocking From the supine position, the participant was asked to bend their hips and knees partially, then arch their lumbar spine, and finally press the bed with their low back. This exercise was performed 10 times per session.
OTHER	2 leg rotation	The patient lies in a crook lying. Both hips are flexed to beyond 90° with knees bent. The therapist supports the pelvis/legs. The knees are brought to the side, limiting the SLR, while rotating the pelvis and trunk as far as possible without pain. The therapist was allowed to change the hip / lumbar position (flexion/extension) if pain is provoked. Sustain for 20 seconds and return to the start position painlessly. Reassess SLR in supine (Wayne Hing et al., 2020).

Timeline

• Start date: 2026-03-15
• Primary completion: 2026-05-30
• Completion: 2026-05-30
• First posted: 2026-03-02
• Last updated: 2026-03-02

Locations

1 site across 1 country: Saudi Arabia