During management of lumbar radiculopathy with extension causing centralization, the clinician should:

• A. Continue to provide feedback and monitor
• B. Return to prone
• C. Return to prone on elbows
• D. Discontinue all extension activities

Answer: (A)

Centralization with extension shows a directional preference for extending the spine. When extension centralizes lumbar radiculopathy symptoms, the best move is to continue with extension-based management and monitor how the patient responds. Keep guiding and progressing extension movements as tolerated, using patient feedback to adjust intensity and repetition so centralized symptoms continue to improve and radicular pain declines. Stopping extension or reverting to flexion-based positions would miss the beneficial direction and slow recovery. Returning to prone or to a prone-on-elbows position isn’t necessary here if extension is helping centralize symptoms, and skipping extension altogether would remove the approach driving improvement.