Conventional physical therapy with lumbar traction; clinical evaluation and magnetic resonance imaging for lumbar disc herniation

Abstract

Objective: This study measures and compares the outcome of conservative physical therapy with traction, by using magnetic resonance imaging and clinical parameters in patients presenting with low back pain caused by lumbar disc herniation. Methods: A total of 26 patients with LDH (14F, 12M with mean aged 37 +/- 11) were enrolled in this study and15 sessions (per day on 3 weeks) of physical therapy were applied. That included hot pack, ultrasound, electrotherapy and lumbar traction. Physical examination of the lumbar spine, severity of pain, sleeping order, patient and physician global assessment with visual analogue scale, functional disability by HAQ, Roland Disability Questionnaire, and Modified Oswestry Disability Questionnaire were assessed at baseline and at 4-6 weeks after treatment. Magnetic resonance imaging examinations were carried out before and 4-6 weeks after the treatment Results: All patients completed the therapy session. There were significant reductions in pain, sleeping disturbances, patient and physician global assessment and disability scores, and significant increases in lumbar movements between baseline and follow-up periods. There were significant reductions of size of the herniated mass in five patients, and significant increase in 3 patients on magnetic resonance imaging after treatment, but no differences in other patients. Conclusions: This study showed that conventional physical therapies with lumbar traction were effective in the treatment of patient with subacute LDH. These results suggest that clinical improvement is not correlated with the finding of MRI. Patients with LDH should be monitored clinically (Fig. 3, Ref. 18). Full Text in free PDF www.bmj.sk.