Comparative Effectiveness of Muscle Energy Technique Combined with Ultrasonic Therapy versus Myofascial Release Combined with Transcutaneous Electrical Nerve Stimulation in Sciatic Nerve Pain due to Prolapsed Intervertebral Disc: A Randomized Controlled Trial

Background: Sciatic nerve pain due to Prolapsed Intervertebral Disc (PIVD) is a common cause of radiating low back pain, reduced mobility, neural tension, and functional disability. Muscle Energy Technique (MET), Myofascial Release (MFR), Ultrasonic Therapy (UST), and Transcutaneous Electrical Nerve Stimulation (TENS) are each individually supported by evidence, but comparative evidence on combined manual-therapyplus-electrotherapy protocols for PIVD-related sciatica remains limited. Objective: To compare the effectiveness of Muscle Energy Technique combined with Ultrasonic Therapy (Group A) against Myofascial Release combined with TENS (Group B) on pain intensity, functional disability, neural mobility, and lumbar range of motion in patients with sciatic nerve pain due to PIVD. Methods: In this randomized controlled trial, 60 participants aged 40–55 years with MRI-confirmed PIVD (4–8 mm disc protrusion) and clinical sciatica were randomly allocated in a 1:1 ratio to Group A (MET + UST, n = 30) or Group B (MFR + TENS, n = 30). Both groups received treatment three sessions per week for 4 weeks. Outcomes were assessed using the Visual Analogue Scale (VAS), the Oswestry Disability Index (ODI), the Straight Leg Raise (SLR) Test, and lumbar Range of Motion (ROM) at baseline and after 4 weeks. Results: Both groups improved significantly on all outcome measures from baseline to post-treatment (all p < 0.05). Group A showed significantly greater improvement than Group B on VAS, ODI, SLR, and ROM at posttreatment (all p < 0.05), with large between-group effect sizes (d = 0.88 to 1.49). Conclusion: Muscle Energy Technique combined with Ultrasonic Therapy produced significantly greater improvement in pain, functional disability, neural mobility, and lumbar range of motion than Myofascial Release combined with TENS, in patients with sciatic nerve pain due to PIVD, over a 4-week period. These findings support MET plus UST as a preferred first-line conservative combination, pending confirmation in a larger, multi-centre, blinded trial.