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Physiotherapy for low back pain


manual therapy and nerve sliders

Low back pain is something that about 80% of us will experience at some point in our lives. About 10 % of those who experience low back pain will also experience symptoms that travel down the leg usually in a predictable pattern, this is often referred to as a radiculopathy. Various body structures or tissues can cause pain to refer down the leg, and they all require different treatment. That’s why it is critical to identify the appropriate reason for your leg pain before assuming it is sciatica.


It is important to be assessed by a qualified health care professional to get a proper diagnosis before beginning an exercise program. Doing the wrong type of exercises for your condition could cause more harm than good.

Two common treatment options for people suffering from sciatica or leg pain associated with low back pain are, neural slider techniques often called ‘neural flossing,’ and joint mobilizations.


Nerve flossing is a gentle treatment or home exercise that stretches irritated nerves to reduce pain and improve range of motion. Nerve flossing tends to work best when combined with other treatments.


Joint mobilization is a skilled passive movement of the articular surface performed by a physiotherapist or other appropriately trained health professional. Joint mobilzations try to restore accessory movements which are necessary for full and pain-free range of motion of joints.


A recent study looked at whether the addition of spinal joint mobilizations improved outcomes when treating people with low back pain and associated radiculopathy.


The Effect of Spinal Mobilization With Leg Movement in Patients With Lumbar Radiculopathy-A Double-Blind Randomized Controlled Trial. Arch Phys Med Rehabil. 2019 May;100(5):828-836. doi: 10.1016/j.apmr.2018.11.004

Contributing Authors: T Hall K Satpute R Bisen P Lokhande


Treatment for both groups included

  • neural slider mobilization techniques

  • lumbar spine range of motion exercises

  • TENS for 30 mins

  • The spinal mobilization group received 5 mins of a side lying gapping technique accompanied with active neural mobilizations of the affected leg

  • Both groups received 6 treatments over 2 weeks.

The group receiving spinal mobilization had a lower leg pain scores, lower back pain scores, lower Oswestry disability index score, greater ROM in straight leg raise (SLR) at 2 weeks, 3 months and 6 months follow-ups compared to the control group.


If you are experiencing low back pain or associated leg pain be sure to get assessed by a qualified physiotherapist at Waterloo Sports Medicine Centre. 


Go to www.wsm.ca to book an assessment online

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Best clinic in the Kitchener, Waterloo and Cambridge area for all your physiotherapy, massage therapy and sports medicine needs. Located near Wilfred Laurier University, University of Waterloo and Connestoga College.
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Best clinic in the Kitchener, Waterloo and Cambridge area for all your physiotherapy, massage therapy and sports medicine needs. Located inside the RIM park sports complex and the Eastbridge neighbourhood.
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