Early Rehabilitation Programs Improve Pain and Disability in Patients with Lumbar Disc Protrusion: A Prospective Controlled Study

Low back pain is a common problem in the active population, and the second reason for visiting a physician. In patients with lumbar disc protrusion, the nucleus pulposus bulges against the disc and the latter protrudes into the spinal column, but the annulus fibrosus remains intact. The purpose of this study was to prove that starting an early complex rehabilitation treatment results into pain and disability reduction, and increased muscle strength and mobility in patients with lumbar disc protrusions. We performed a prospective cohort study, enrolling 60 patients (25 men and 35 women) aged between 26 to 76 years, diagnosed with lumbar disc protrusion. Patients in the experimental group registered significant improvements in all studied variables (pain, mobility, muscle strength, disability) after 6 months of treatment. The results of our study suggest that, in the lumbar disc disease, a combined rehabilitation program may be more effective in terms of pain and disability reduction, if it starts early after diagnosis. The current study proves the importance of combining electrotherapy with hydrotherapy and physical therapy. Patients who received this treatment combination showed an extremely significant improvement in pain relief, and reduction of functional disability after 6 months of treatment.

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Taming of the Testicular Pain Complicating Lumbar Disc Herniation With Spinal Manipulation

American Journal of Men s Health ◽

10.1177/1557988320949358 ◽

2020 ◽

Vol 14 (4) ◽

pp. 155798832094935

Author(s):

Eric Chun Pu Chu

Keyword(s):

Lumbar Spine ◽

Lumbar Disc ◽

Low Back ◽

Chiropractic Treatment ◽

Disc Disease ◽

Lumbar Disc Disease ◽

Disc Protrusion ◽

Testicular Pain ◽

History Of ◽

Magnetic Resonance Imaging Mri

Degenerative disease of the lumbar spine is often ignored as a potential cause of testicular pain because the exact link between the two remains uncertain. This article reports the case of a 60-year-old man with a 3-year history of low back pain and unexplained right testicular pain for 2 years. Painful symptoms were negatively affecting his social, physical, and sexual functions. After failure to achieve pain relief through multiple types of therapy, the patient sought chiropractic treatment for his condition. Lumbar spine magnetic resonance imaging (MRI) revealed disc protrusion at the L1/L2, L3/L4, and L4/L5 segments causing thecal sac indentations. Due to the absence of direct testicular causes, the medical impression was chronic testicular pain (CTP) complicating lumbar disc disease. The patient experienced regular improvement in his low back and testicular pain with complete resolution of both after 8 weeks of chiropractic treatment. This article describes an overlook of the etiology of this patient’s testicular pain and a successful option in treating the patient. CTP has multifactorial etiology. An excellent treatment outcome depends heavily on recognizing the origin of the pain.

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The Catheter Tip Position and Effects of Percutaneous Epidural Neuroplasty in Patients with Lumbar Disc Disease During 6-Months of Follow-up

January 2018 - Pain Physician ◽

10.36076/ppj.2014/17/e599 ◽

2014 ◽

Vol 5;17 (5;9) ◽

pp. E599-E608 ◽

Cited By ~ 1

Author(s):

Prof. Dong Ah Shin

Keyword(s):

Back Pain ◽

Clinical Outcomes ◽

Lumbar Disc ◽

Controlled Study ◽

Disc Disease ◽

Catheter Position ◽

Lumbar Disc Disease ◽

Single Level ◽

Catheter Tip

Background: Percutaneous epidural neuroplasty (PEN) is a minimally invasive intervention designed to treat neck, back, and low back pain. The efficacy of lumbar PEN has been relatively well investigated, but clinical effectiveness according to catheter position has not yet been established. Objective: The purpose of this study was to compare clinical outcomes between the ventral and dorsal positions of the catheter tip during lumbar PEN procedures using a retrospective review series. Methods: A total of 303 patients with back pain from single-level lumbar disc disease with and without radiculopathy were included in this study. In all patients, an attempt was made to place the catheter tip in the ventral position to maximize theoretical clinical improvement; however, several catheters failed to reach the desired position. Patients were assigned to 2 groups after lumbar PEN procedures were completed: those with catheters in the ventral position (Ventral group) and those with catheters in the dorsal position (Dorsal group). Clinical outcomes were assessed according to the Visual Analog Scale (VAS) score for back pain and leg pain at 0, 1, 3, and 6 months after treatment. Results: The only demographic difference observed between the 2 groups (Ventral and Dorsal groups) was an elongated symptom duration in the Dorsal group compared to the Ventral group (16.1 vs. 9.4 months, P = 0.013). The VAS (back) scores during the follow-up period (1, 3, and 6 months) were similar between the 2 groups. In one area of the VAS scoring (leg), the Ventral group showed a similar effect at postoperative one month compared to the Dorsal group, but significantly improved at postoperative 3 and 6 months (1.3 and 0.9 in ventral group, and 1.9 and 1.4 in dorsal group, respectively; P = 0.002 and 0.010). Odom’s criteria were also significantly improved over 6 months in the Ventral group compared to the Dorsal group. Limitations: This study was a retrospective analysis with a relatively short follow-up duration was not a randomized, controlled study. Therefore, the clinical effects of the catheter position could be confounded by other variables. Conclusion: In this short-term follow-up study, the effects of lumbar PEN on VAS scores were different according to the position of the catheter tip in patients with single-level lumbar disc herniation. Better outcomes in the Ventral group may have been achieved by more localized treatment with a selective block in the epidural space closer to the dorsal root ganglion and ventral aspect of the nerve root. Key words: Lumbar disc disease, pain management, percutaneous epidural neuroplasty, catheter position, dorsal, ventral

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Preoperative paraspinal and psoas major muscle atrophy and paraspinal muscle fatty degeneration as factors influencing the results of surgical treatment of lumbar disc disease

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-03754-x ◽

2021 ◽

Author(s):

Agnieszka Stanuszek ◽

Adrian Jędrzejek ◽

Eliza Gancarczyk-Urlik ◽

Izabela Kołodziej ◽

Magdalena Pisarska-Adamczyk ◽

...

Keyword(s):

Surgical Treatment ◽

Muscle Atrophy ◽

Lumbar Disc ◽

Fatty Degeneration ◽

Paraspinal Muscle ◽

Disc Disease ◽

Lumbar Disc Disease ◽

Factors Influencing ◽

Psoas Major Muscle ◽

Psoas Major

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Does the Intradiscal Injection of Platelet Rich Plasma Have Any Beneficial Role in the Management of Lumbar Disc Disease?

Global Spine Journal ◽

10.1177/2192568221998367 ◽

2021 ◽

pp. 219256822199836

Author(s):

Sathish Muthu ◽

Madhan Jeyaraman ◽

Girinivasan Chellamuthu ◽

Naveen Jeyaraman ◽

Rashmi Jain ◽

...

Keyword(s):

Beneficial Effect ◽

Platelet Rich Plasma ◽

Lumbar Disc ◽

Meta Analysis ◽

Cochrane Library ◽

Significant Heterogeneity ◽

Disc Disease ◽

Lumbar Disc Disease ◽

Beneficial Role ◽

Sf 36

Study Design: Systematic review and meta-analysis. Objectives: We performed this meta-analysis to evaluate whether intradiscal Platelet Rich Plasma(PRP) injection has any beneficial role in the management of lumbar disc disease. Methods: We conducted independent and duplicate electronic database searches including PubMed, Embase, and Cochrane Library till September 2020 for studies investigating the role of intradiscal PRP in the management of lumbar disc disease. The analysis was performed in the R platform using OpenMeta[Analyst] software. Results: 13 studies including 2 RCTs, 5 prospective, and 6 retrospective studies involving 319 patients were included in the meta-analysis. A single-arm meta-analysis of the included studies showed a beneficial effect of the intervention in terms of pain relief outcomes like VAS score (p < 0.001), pain component of SF-36 (p = 0.003) while such improvement was not seen in functional outcome measures like ODI score (p = 0.071), the physical component of SF-36 (p = 0.130) with significant heterogeneity noted among the included studies. No structural improvement in magnetic resonance imaging was observed (p = 0.106). No additional procedure-related adverse events were noted in the included studies (p = 0.662). Conclusion: There is a paucity of high-quality studies to give conclusive evidence on the benefits of intradiscal PRP for lumbar disc disease. Although intradiscal PRP injection has shown some beneficial effect in controlling pain for lumbar disc disease, we could not find structural or functional improvement from the included studies. Hence, we recommend large double-blind double-arm randomized controlled studies to analyze the benefits of the intervention being analyzed.

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