Eficacia de la terapia manual y ejercicio terapéutico de control motor en dolor de origen radicular lumbar. Una revisión sistemática

DOI: https://doi.org/10.46296/gt.v9i18edespsep.0442 Abstract Lumbar radicular pain represents a highly disabling neuromuscular condition and a primary cause of physical therapy and musculoskeletal rehabilitation clinical consultation worldwide. This research aimed to qualitatively evaluate the clinical effectiveness of combining manual therapy and motor control therapeutic exercise versus monotherapeutic or passive interventions in adult patients with compressive lumbar radiculopathy. We structured a qualitative systematic literature review following the PRISMA 2020 statement reporting guidelines and Cochrane methodological principles. Based on a structured clinical question formulated using the PICO strategy, we conducted an exhaustive search across electronic databases, including SciELO, PubMed, PEDro, and Google Scholar, for the 2021-2025 publication period using advanced Boolean syntax. From an initial universe of 142 identified records, 10 key scientific articles of high methodological quality (randomized controlled trials and meta-analyses) were selected, evaluating risk of bias, through the PRISMA flow diagram. Qualitative synthesis confirms that combining manual therapy and motor control exercise yields significantly superior outcomes in reducing neuropathic pain intensity (VAS/NPRS) and decreasing Oswestry Disability Index (ODI) scores across all clinical follow-up stages. Manual therapy provides rapid neurophysiological analgesic modulation and transient mechanical decompression, facilitating active retraining of the deep stabilizing musculature (transversus abdominis and multifidus) and reversing arthrogenic muscle inhibition. Furthermore, neural desensitization, increased straight leg raise (SLR) range of motion, and a significantly lower 12-month symptom recurrence rate were consistently observed. In conclusion, the systematic evidence shows that multimodal therapeutic integration is the most robust, comprehensive, and effective first-line conservative rehabilitation strategy for managing lumbar radicular pain. Keywords: lumbar radicular pain; manual therapy; motor control; neurodynamics; systematic review.