A New Perspective on Lumbar Disc Herniation Management Using Prone Knee Extension

Lumbar disc herniation (LDH) is a frequent cause of low back pain and radiculopathy, often resulting in diminished functional capacity and a lower quality of life. Nonsurgical interventions are frequently sought to manage symptoms and enhance spinal stability. This case report explores a novel application of the prone knee extension (PKE) exercise as part of a comprehensive physiotherapy regimen aimed at addressing pain, mobility limitations, and functional impairments in a patient with LDH.

A 34-year-old male with a history of LDH and radiating lower limb symptoms presented with an acute exacerbation following heavy physical activity. MRI confirmed a disc protrusion at the L4-L5 level. The patient reported severe pain, restricted lumbar extension, and functional limitations. A 5-week treatment plan was implemented, consisting of 10 physiotherapy sessions combining the PKE exercise, infrared heat therapy, dry needling, diaphragmatic breathing, and core stability exercises, alongside a home exercise program. Significant improvements were observed, including pain reduction, resolution of radiating symptoms, increased lumbar range of motion, and improved sleep quality. Functional assessments using the Oswestry Disability Index (ODI) and Global Rating of Change (GRC) Scale demonstrated reduced disability and enhanced overall function.

This case highlights the potential effectiveness of integrating the PKE exercise into the management of LDH. The approach facilitated pain relief, improved health status, and enhanced functional capacity, suggesting that it could serve as a valuable nonsurgical intervention in clinical practice. However, as the findings are preliminary, further research is needed to validate these results.