The Alexander technique vs. the McKenzie method in the treatment of lumbosacral radiculopathy

Low back pain (LBP) is the most common musculoskeletal problem worldwide. Up to 85% of people will experience low back pain during their lifetime. LBP has a great impact on quality of life, lifestyle, and work-related disability. Each year, the costs of LBP in the United States exceed $100 billion. Lumbosacral, referring to the lumbar and sacral region of the spinal cord, radiculopathy, meaning a disorder of the nerve root, is sometimes referred to as sciatica and is a condition in which a disease process affects the function of one or more lumbosacral nerve roots. The most common cause is structural – disc herniation – leading to root compression. Intervertebral discs are located between vertebrae in the spinal column to supply cushion, absorb physical shock to the spinal column, and protect the nerves traveling the center of the spine. Intervertebral discs are composed of two different tissue layers, an interior layer called the nucleus pulposus, and an exterior layer called the annulus fibrosus. The nucleus pulposus is a gel-like layer that can absorb force due to its fluid nature and the annulus fibrosus has multiple layers of fibrocartilage that encompasses the nucleus pulposus and keeps it inside the disc. The annulus fibrosus is able to withstand a lot of pressure but can rupture due to age or from significant pressure being exerted on it from the nucleus pulposus. A bulging disc results if some, but not all, of the layers of the annulus fibrosus rupture and cause a portion of the nucleus pulposus to obtrude into the annulus fibrosus. A herniated disc results if the nucleus pulposus bursts through all the layers of the annulus fibrosus and begins to leak into the spinal column. Lumbar nerve roots branch out from the spinal cord via the intervertebral foramen. A bulging or herniated intervertebral disc can put pressure on these nerves creating various symptoms including pain, tingling, sensory loss, or partial paralysis of affected muscles along the dermatome of the affected nerve. The aim of this review is to discuss the prognosis and treatment of lumbosacral radiculopathy. This review will also limit itself to non-operative, non-neoplastic, and noninfectious causes of lumbosacral radiculopathy