Effects of Neural Mobilization Combined With Manual Therapy on Infrared Thermography, Inflammatory Markers and Clinical Outcomes in Patients With Lumbar Disc Herniation: A Randomized Controlled Clinical Trial

The objective of this randomized controlled clinical trial is to evaluate whether manual therapy combined with neural mobilization can improve pain, functional impairment, quality of life, inflammatory markers, and infrared thermographic findings in patients with lumbar disc herniation. The study subjects consist of 72 patients with lumbar disc herniation (aged 18-65 years, with unilateral lumbar radicular symptoms). The primary questions it aims to address are: 1. In patients with lumbar disc herniation, is manual therapy combined with neural mobilization more effective than manual therapy alone in relieving pain and improving functional impairment? 2. Can manual therapy combined with neural mobilization improve patients' quality of life, inflammation-related markers (IL-6 and TNF-α), and body temperature changes detected by infrared thermography? The researchers compared: * Experimental group: manual therapy combined with neural mobilization (36 cases) * Control group: manual therapy with sham neural mobilization (36 cases) to determine whether adding neural mobilization can provide additional therapeutic effects, including better pain relief, functional recovery, and improvement in related physiological indicators. Participants will: * Receive a 3-week course of treatment, totaling approximately 11 sessions. * Undergo standardized manual therapy, including lumbar mobilization and soft tissue therapy, to help relieve pain and improve mobility. * Receive additional treatment according to group assignment: * The experimental group will receive sciatic nerve mobilization through gentle, controlled leg movements to improve nerve function and reduce nerve sensitivity. * The control group will receive lumbar traction therapy to relieve lumbar stress. * Be assessed before and after treatment, including pain scores, functional impairment scores (ODI), quality of life surveys (SF-12), infrared thermography examinations, and blood tests for inflammatory markers.

Inclusion Criteria: \- Participants will be eligible for inclusion if they meet the following criteria: Adults aged 18-65 years. Diagnosis of lumbar disc herniation based on clinical symptoms and imaging findings. Presence of unilateral lumbar radiculopathy. Persistent symptoms despite initial conservative management. Ability to participate in the intervention protocol. Provided written informed consent before study enrollment. Exclusion Criteria: \- Participants will be excluded if they meet any of the following criteria: Requirement for surgical intervention for lumbar disc herniation. Serious spinal conditions, including spinal infection, tumor, or fracture. Severe systemic diseases or acute inflammatory conditions. Pregnancy or breastfeeding. Receipt of other interventions that may affect study outcomes during the study period.