Physiotherapy Management of Lumbar Herniated Nucleus Pulposus: A Case Report

Abstract

Introduction: Lumbar Herniated Nucleus Pulposus (HNP) is a spinal disorder characterized by protrusion of the intervertebral disc beyond its anatomical boundaries, frequently compressing adjacent nerve roots. This condition commonly presents with lower back pain, radicular pain, reduced spinal mobility, altered gait, and both sensory and motor impairments, ultimately diminishing quality of life.

Methods: This case report describes a young adult patient presenting with right-sided radicular pain, decreased lower limb muscle strength, and diminished deep tendon reflexes. The physiotherapy intervention included Microwave Diathermy (MWD), McKenzie exercises, Bugnet exercises, and targeted stretching techniques.

Results: After a single physiotherapy session, the patient experienced a reduction in pain intensity from 7 to 4 on the Numerical Rating Scale (NRS) and demonstrated increased lumbar flexibility.

Discussion: This case illustrates the short-term effectiveness of a multimodal physiotherapy approach in managing lumbar HNP. The combination of MWD and McKenzie exercises appeared to provide rapid symptom relief, particularly in young patients with radicular symptoms. These findings are consistent with existing literature highlighting the role of exercise therapy and physical modalities in reducing pain and improving function in HNP patients. However, the results should be interpreted with caution due to the single-session intervention and the case report design, which limits generalizability.

Conclusion: A multimodal physiotherapy approach incorporating MWD, McKenzie, and stretching exercises may be effective in reducing pain and improving lumbar mobility in patients with HNP. Further longitudinal and controlled studies are needed to establish long-term efficacy and optimize treatment protocols.