Sciatica Due to Intervertebral Disc Disorder(MWM)NCT07444125
Two-leg Rotation and Sciatica
A study testing standard physical therapy and 2 leg rotation in people with Sciatica Due to Intervertebral Disc Disorder, run by University of Hail at 1 site in Saudi Arabia.
Trial 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. Read more about this study
- Who is it for?
- Ages 18 to 50 years
- Conditions the study is for
- Sciatica Due to Intervertebral Disc Disorder
- What is being tested?
- standard physical therapy and 2 leg rotation
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 80 participants
- Where
- 1 siteSaudi Arabia
- Study dates
- 15 Mar 2026to 15 Aug 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 50 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Both genders.
- Age between 18 and 50
- Have lumbar discogenic lesions.
- Having sciatica symptoms extending down to the knee.
Who cannot join
- Surgical operation in the lumbar spine
- Severe discogenic lesions with bladder or fecal incontinence or progressive muscular weakness.
- Piriform syndrome.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Effect of Adding Two Leg-rotation to Standard Physical Therapy in the Treatment of Sciatica Secondary to Lumbar Discogenic Lesions.
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
Read the 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.
- Being tested
- standard physical therapy, 2 leg rotation
- Keywords
- Sciatica, lumbar disc lesion, Mulligan concept, function, physiotherapy
- Medical subject headings
- Sciatica
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
standard physical therapyOther
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.
2 leg rotationOther
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).
| Study group | Role | What they receive |
|---|---|---|
| standard physical therapy | Active comparator | this group of participants will recieve standard physical therapy care consisted of trans cutanous electrical nerve stimulation + ultrasound+ superficial heat and therapeutic exercises including pelvic tilting exercises Receives: Other: standard physical therapy |
| 2 leg rotation | Experimental | this group of participants will recieve the same intervention introduced to the standard physical therapy arm in addition to the 2 leg rotation technique of manual concept. Receives: Other: standard physical therapy; Other: 2 leg rotation |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain by the numeric pain rating scale
The Numeric Pain Rating Scale (NPRS) is a unidimensional 0-to-10 measure, where 0 denotes "no pain" and 10 signifies "worst imaginable pain." Participants indicated their current pain intensity by choosing the number that best reflected their experience (H. Hussein, Atteya, et al., 2024). Previous investigations have confirmed the NPRS's strong psychometric properties, reporting validity and reliability coefficients of 0.941 and 0.95, respectively (Alghadir et al., 2018).
Measured: at baseline and after the end of intervention (after 4 weeks of intervention)
Flexibility measured by the passive straight leg raise test
The passive straight leg raise (SLR) test was performed with the participant supine. The assessor passively elevated the symptomatic lower limb in the sagittal plane until the participant experienced their typical symptoms or hamstring tightness limited further motion. Upon symptom onset, the assessor documented the type, severity, location, and whether the symptoms matched the participant's usual pain. Then, the assessor lowered the limb slightly until the symptoms subsided. Next, passive ankle dorsiflexion and active neck flexion were applied to determine if symptoms could be reproduced. The interpretation is deemed positive when all of the following criteria are satisfied:
- Symptoms occur below the gluteal region. Symptoms are familiar to the participant (match their usual pain or discomfort),
- Symptoms are elicited during limb elevation (e.g., straight-leg raise).
- Symptoms are re-elicited by adding ankle dorsiflexi
Measured: at baseline and after the end of the intervention (after 4 weeks of intervention)
Function by the Oswestry disability index.
A validated Arabic version of the Oswestry Disability Index (ODI) was used to assess function. This scale consisted of ten sections, each describing a different domain of function. Each one of these sections contains six phrases, which are scored from 0 to 5.
The maximum score is 100, which indicates the worst functional ability, while lower scores indicate better function. Each participant was instructed to choose the most appropriate statement from each section of the ODI. The values of all statements chosen by the participants were added, and the total score was then used for analysis (Hussien et al., 2017).
Measured: at baseline and after the end of the intervention (after 4 weeks of intervention)
Sciatica bothersomeness and frequency by Sciatica bothersomeness and frequency scale
The Sciatica Frequency Index asks patients to indicate how often they experience each of the symptoms covered by the Sciatica Bothersomeness Index (SBI). In fact, the concept of "bothersomeness" has become a common way to quantify symptoms in sciatica and low back pain. For this reason, we selected the SBI as the best tool for capturing patients' own perceptions of their sciatica symptoms in the current study. The Sciatica Bothersomeness Index employs a uniform format to assess four key complaints: leg pain, numbness or tingling in the leg, foot, or groin, weakness in the leg or foot, and back or leg pain when sitting. Patients rated the severity of each symptom, and the ratings were summed to produce a total SBI score. The index has been featured in multiple investigations, and three of its items have been incorporated into the North American Spine Society's outcome instrument (Grøvle et al., 2010).
Measured: at baseline and after the end of the intervention (after 4 weeks of intervention)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Mar 2026
- Study start15 Mar 2026
- Primary completion15 Aug 2026
- Study completion15 Aug 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Sciatica Due to Intervertebral Disc DisorderStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- double-blind 2 groups pretest-post test randomized controlled trial
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 80 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Hail
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Hisham Mohamed Hussein, University of Hail
- Investigators
- Hisham M Mohamed, PhD, Principal investigator, University of Hail, College of Applied Medical Sciences
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07444125
- Sponsor's protocol ID
- H-2026-039
- Acronym
- (MWM)
- Status last verified
- Sep 2026
- First submitted
- 24 Feb 2026
- Last updated
- 10 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: raw data will be available with the pricnciple investigator upon reasinable request
Study at a glance
From the registry record, last updated by the sponsor on 10 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Adding Two Leg-rotation to Standard Physical Therapy in the Treatment of Sciatica Secondary to Lumbar Discogenic Lesions.
- ClinicalTrials.gov ID
- NCT07444125
- Acronym / sponsor ID
- (MWM) / H-2026-039
- Keywords
- Sciatica, lumbar disc lesion, Mulligan concept, function, physiotherapy
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 80 participants (actual)
- Lead sponsor
- University of HailUniversity, hospital or other
- Study start
- 15 Mar 2026 (actual)
- Primary completion
- 15 Aug 2026 (actual)
- Study completion
- 15 Aug 2026 (actual)
- First posted
- 2 Mar 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
- Model description
- double-blind 2 groups pretest-post test randomized controlled trial
| Arm | Type | Receives |
|---|---|---|
| standard physical therapy | Active comparator | Other: standard physical therapythis group of participants will recieve standard physical therapy care consisted of trans cutanous electrical nerve stimulation + ultrasound+ superficial heat and therapeutic exercises including pelvic tilting exercises |
| 2 leg rotation | Experimental | Other: standard physical therapy, Other: 2 leg rotationthis group of participants will recieve the same intervention introduced to the standard physical therapy arm in addition to the 2 leg rotation technique of manual concept. |
Who may qualify
- Ages
- 18 to 50 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- Both genders.
Key exclusion criteria (3 listed)
- Surgical operation in the lumbar spine
- Severe discogenic lesions with bladder or fecal incontinence or progressive muscular weakness.
- Piriform syndrome.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| standard physical therapyModalities (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, standard physical therapy |
| 2 leg rotationThe 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). | Other | 2 leg rotation |
Primary outcome
Pain by the numeric pain rating scale
Time frame: at baseline and after the end of intervention (after 4 weeks of intervention)
The Numeric Pain Rating Scale (NPRS) is a unidimensional 0-to-10 measure, where 0 denotes "no pain" and 10 signifies "worst imaginable pain." Participants indicated their current pain intensity by choosing the number that best reflected their experience (H. Hussein, Atteya, et al., 2024). Previous investigations have confirmed the NPRS's strong psychometric properties, reporting validity and reliability coefficients of 0.941 and 0.95, respectively (Alghadir et al., 2018).
Flexibility measured by the passive straight leg raise test
Time frame: at baseline and after the end of the intervention (after 4 weeks of intervention)
The passive straight leg raise (SLR) test was performed with the participant supine. The assessor passively elevated the symptomatic lower limb in the sagittal plane until the participant experienced their typical symptoms or hamstring tightness limited further motion. Upon symptom onset, the assessor documented the type, severity, location, and whether the symptoms matched the participant's usual pain. Then, the assessor lowered the limb slightly until the symptoms subsided. Next, passive ankle dorsiflexion and active neck flexion were applied to determine if symptoms could be reproduced. The interpretation is deemed positive when all of the following criteria are satisfied: * Symptoms occur below the gluteal region. Symptoms are familiar to the participant (match their usual pain or discomfort), * Symptoms are elicited during limb elevation (e.g., straight-leg raise). * Symptoms are re-elicited by adding ankle dorsiflexi
Function by the Oswestry disability index.
Time frame: at baseline and after the end of the intervention (after 4 weeks of intervention)
A validated Arabic version of the Oswestry Disability Index (ODI) was used to assess function. This scale consisted of ten sections, each describing a different domain of function. Each one of these sections contains six phrases, which are scored from 0 to 5. The maximum score is 100, which indicates the worst functional ability, while lower scores indicate better function. Each participant was instructed to choose the most appropriate statement from each section of the ODI. The values of all statements chosen by the participants were added, and the total score was then used for analysis (Hussien et al., 2017).
Sciatica bothersomeness and frequency by Sciatica bothersomeness and frequency scale
Time frame: at baseline and after the end of the intervention (after 4 weeks of intervention)
The Sciatica Frequency Index asks patients to indicate how often they experience each of the symptoms covered by the Sciatica Bothersomeness Index (SBI). In fact, the concept of "bothersomeness" has become a common way to quantify symptoms in sciatica and low back pain. For this reason, we selected the SBI as the best tool for capturing patients' own perceptions of their sciatica symptoms in the current study. The Sciatica Bothersomeness Index employs a uniform format to assess four key complaints: leg pain, numbness or tingling in the leg, foot, or groin, weakness in the leg or foot, and back or leg pain when sitting. Patients rated the severity of each symptom, and the ratings were summed to produce a total SBI score. The index has been featured in multiple investigations, and three of its items have been incorporated into the North American Spine Society's outcome instrument (Grøvle et al., 2010).
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Sep 2026.
- Individual participant dataSharing planned: Yes. raw data will be available with the pricnciple investigator upon reasinable request
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Electroacupuncture for Insomnia in Patients With Chronic Sciatica Due to Lumbar Disc Herniation: a Randomized Controlled Trial
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Hisham M Mohamed, PhD principal investigator
University of Hail, College of Applied Medical Sciences
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing standard physical therapy and 2 leg rotation in people with Sciatica Due to Intervertebral Disc Disorder, run by University of Hail at 1 site in Saudi Arabia.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 10 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Saudi Arabia. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pain by the numeric pain rating scale (time frame: at baseline and after the end of intervention (after 4 weeks of intervention)). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Sep 2026.