Comparative evaluation of the analgesic effectiveness of selected physiotherapeutic methods in the treatment of low back pain syndrome

Jolanta Kujawa, Iwona Pyszczek, Jan Talar, Mirosław Janiszewski

Jolanta Kujawa, Iwona Pyszczek, Jan Talar, Mirosław Janiszewski – Comparative evaluation of the analgesic effectiveness of selected physiotherapeutic methods in the treatment of low back pain syndrome. Fizjoterapia Polska 2001; 1(3); 271-279

Abstract

Background. Low back pain, especially lumbosacral syndrome, is the most frequently encountered pain syndrome in musculoskeletal diseases. In many countries the question of low back pain has become a social problem. The basic task of rehabilitation teams is to make the proper choice of effective physiotherapeutic method. The goal of this study was to evaluate the analgesic effectiveness of selected combined physiotherapeutic methods in patients with low back pain. The results were analyzed for statistically significant differences correlating with the application of particular physical methods.Material and methods. 450 randomly selected patients (319 females, 131 males), age 21-79 (average age 56,53 years +/- 15,34) treated for low back pain syndrome in the Department of Medical Rehabilitation at the Łódź-Śródmieście Municipal Clinic were surveyed. Patients were divided into two groups: Group A received laser biostimulation, while Group B received interferential current instead of laser therapy. All patients studied went through a uniform, typical program of therapeutic exercises.The effectiveness of this combined therapy was evaluated on the basis of subjective pain reported on the modified Laitinen pain questionnaire, taking into account intensity, frequency, use of analgesics and motor activity. A clinical examination was also performed. Results. The investigation indicated that both selected combined physiothearapeutic methods have a measurable analgesic effect in the treatment in low back pain. However, laser therapy applied in combination with therapeutic exercises proved to have greater therapeutic efficiency for such patients compared to interferential current with therapeutic exercises, and this difference was statistically significant.

Key words:
low power laser therapy, Low Back Pain, physiotherapy
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Evaluating the manner of performing selected activities of daily living in the light of early prevention of low back pain

Aleksandra Rudzińska, Olga Nowotny-Czupryna, Henryk Knapik

Aleksandra Rudzińska, Olga Nowotny-Czupryna, Henryk Knapik – Evaluating the manner of performing selected activities of daily living in the light of early prevention of low back pain. Fizjoterapia Polska 2001; 1(4); 381-384

Abstract
Background. Low back pain is both a medical and a social problem. One way to limit its dimensions is prevention, broadly understood. In our research we attempted to determine how activities of daily living that are particularly burdensome for the spine are performed. Material and methods. Our research involved 265 healthy subject (i.e. without spinal pain symptoms at the moment of testing), among whom 136 were manual laborers and 129 were white-collar workers. The subject were asked to perform 3 movement tasks: to change body position from lying to standing, to assume a sitting position on a chair, and to lift a weigh from the floor. Results. The results we obtained indicate a lack of proper movement habits, which are essential in the prevention of low back pain in the great majority of subjects. Conclusions. It would be advisable to conduct training in the area of preventing strain on the spine, as a result of which spinal pain symptoms can develop. The general public should be made aware of the importance of the problem, with particular emphasis on the consequences of the errors committed on a daily basis.

Key words:
Low Back Pain, prevention, back school

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The treatment of herniated disks in the lumbo-sacral spine

M. Śniegocki, H. A. Kasprzak

M. Śniegocki, H. A. Kasprzak – The treatment of herniated disks in the lumbo-sacral spine. Fizjoterapia Polska 2002; 2(2); 128-133

Abstract
This article presents contemporary methods of surgical treatment for application in patients with herniated disk. In discussing the various methods the authors concentrate on indications and counterindications for their application. In view of possible complications, the necessity is stressed to perform precise neuroimaging diagnostics as a basis for making the decision whether or not to operate and further rehabilitation.

Key words:
lumbo-sacral discopathy, Low Back Pain, surgical treatment

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Biomechanical aspects of low back pain in equestrian riders

Ewa Hordyńska, Józef Opara

Ewa Hordyńska, Józef Opara – Biomechanical aspects of low back pain in equestrian riders. Fizjoterapia Polska 2002; 2(3); 235-240

Abstract
Back pain, from social standpoint, belongs to the most important illnesses, despite the fact that it does not pose a direct life threat. Eighty per cent of adults are estimated to suffer from back pain daily. Most frequently, though, the true reasons, for the illness remain unknown. However, revealing factors that influence the occurrence of back pain in riders, and especially dressage riders, may be of considerale preventive importance. The paper presents problems that arise im movement relation between the rider and the horse in view of biomechanics of the seat.

Key words:
Biomechanics, Low Back Pain, rider

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Rehabilitation results in patients after operation of discopathy in lumbo-sacral section

Teresa Pop, Krzysztof Kołodziej, Maria Pabis, Grzegorz Przysada, Piotr Szpunar

Teresa Pop, Krzysztof Kołodziej, Maria Pabis, Grzegorz Przysada, Piotr Szpunar – Rehabilitation results in patients after operation of discopathy in lumbo-sacral section. Fizjoterapia Polska 2002; 2(4); 280-284

Abstract
Background. In results from data in literature and our observations that 2% of patients with the low back pain requires operational treatment. The work presents algorithm of rehabilitation of patients after the operation of removing the nucleus pulposus in the lumbosacral section. Material and methods. Twenty patients were examined, who in a period of November 2000 till March 2001 were operated at the Neurosergical Department and rehabilitated in the Physiotherapy Laboratory of the Rehabilitation Department of the District Hospital No. 2 in Rzeszów. In order to evaluate pain a visual analogue scale VAS and five-points Likert’s scale were used. The examination was performed three times: before and after the surgery and after a three weeks’ period of rehabilitation. Results and conclusions. The algorithm of procedure in the post-surgery period was proposed, in which complex rehabilitation was taken into consideration, among others physiotherapy, psychotherapy, pharmacotheraphy, professional advising, teaching ergonomy of labour and rest.

Key words:
discopathy, Low Back Pain, nucleus pulposus, Likert’s scale

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Assessment of the effectiveness of medical massage in patients with low back pain

Waldemar Andrzejewski, Krzysztof Kassolik, Anna Karaś, Grzegorz Karaś, Ewa Trzęsicka

Waldemar Andrzejewski, Krzysztof Kassolik, Anna Karaś, Grzegorz Karaś, Ewa Trzęsicka – Assessment of the effectiveness of medical massage in patients with low back pain – research report. Fizjoterapia Polska 2006; 6(2); 150-156

Abstract

Background. Low back pain is a very often reported disorder in physiotherapist’s office. Medical massage is one of the most popular method to treat this kind of problem. The main difference between medical and classical massage depends on its methodology. In medical massage it is crucial to include the structural relationship between soft tissues. In order to find an effective treatment method therapist must treat patients as a whole, as a number of connected with each other structures. To assess the effectiveness of medical massage in people with low back pain problems. Material and methods. Twenty eight patients with low back pain have taken part in the research. Anamnesis was taken from all the patients, they also had a palpation examination to evaluate the intensity of pain in tissues. The evaluation was taken before the treatment, after the sixth and the last procedure of medical massage. Patients had one set consisting of 10 procedures. Time duration of each procedure was between 40-70 minutes. It was supposed that the painful area means disorder with an increased tension in this place. Structures which had bigger tenderness were massaged. Subjects were in prone or lying on their side position in order to maintain relaxed conditions. Classical techniques were used: stroking, petrissage, kneading, and vibration by the same therapist in all subjects. Results. There has been a significant decrease in both number of painful areas and pain intensity reported by patients. Conclusion. Medical massage is an effective therapeutic method to work on patients with low back pain. The effectiveness of massage was observed after six procedures, and after the sixth massage patients reported only slight pain.

Key words:
low back pain, medical massage, pain evaluation
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Interpretation of the results of physiotherapy for low back pain based on the Ryodoraku electrodermal measurements

Andrzej Żytkowski, Henryk Chmielewski, Beata Wrodycka

Andrzej Żytkowski, Henryk Chmielewski, Beata Wrodycka – Interpretation of the results of physiotherapy for low back pain based on the Ryodoraku electrodermal measurements. Fizjoterapia Polska 2007; 7(4); 392-400

Abstract
Background. The aim of this study was to analyse skin conductance of a direct current (galvanic skin response, GSR) in dermatomes corresponding to the level of discopathy and to provide an indirect objective interpretation of several commonly used physiotherapeutic methods: low frequency diadynamic currents, medium frequency interferential currents, low frequency pulsed magnetic therapy and classic acupuncture. Material and methods. Tests of GSR, an indirect measure of sympathetic activity, were carried out in addition to clinical assessment and radiological studies in a group of 164 patients with diagnosed low back pain [65 persons with a pseudoradicular pain syndrome and 99 patients with evident sciatic neuralgia], using the diagnostic component of Yoshio Nakatani’s Ryodoraku method. The essence of the method is the measurement of skin conductance of a 200 uA direct current at 24 points of the body regarded as representative of systemic sympathetic activity. Results. There was no correlation between the clinical characteristics of a pain syndrome and GSR changes. Skin conductance values significantly more often fell within the normal range following exposure to a low frequency magnetic field compared of the other physical therapy methods investigated in the study. Conclusions. The following conclusions can be made on the basis of the observed outcomes: 1. The Ryodoraku method is non-specific and inappropriate as an additional tool for the diagnosis of sciatic neuralgia; 2. Some correlations can be established between conductance measurements and the physical treatment method used.
Key words:
low back pain, electrodermal measurements of Ryodoraku, physiotherapy
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Centralisation and peripheralisation of symptoms according to McKenzie Method among patients with chronic low back pain

Aleksandra Truszczyńska

Aleksandra Truszczyńska – Centralisation and peripheralisation of symptoms according to McKenzie Method among patients with chronic low back pain. Fizjoterapia Polska 2011; 11(4); 351-356

Abstract
Background. Diagnosis of lumbar sciatica is based on classical neurological examination and radiographic imaging. In literature, McKenzie described detailed functional tests concerning pain response during mechanical procedures. Centralisation of pain confirmed during examination informs the examiner that conservative treatment is indicated. Contrary to that peripheralisation of symptoms, it confirms that derangement is irreducible. The aim of the study was to show that the method of functional exa­mination enables diagnosis of centralisation or peripheralisation of pain among chronic patients with sciatica. The additional aim was to determine the factors identified from objective evaluation which determine further treatment of these patients. Material and methods. 200 patients with low back pain and sciatica were precisely analysed. There were 84 men (42%) and 116 women (58%), age between 13-79 years (43.0±13,65). Peripheralisation of pain was found in 65 patients (group A), and centralisation – in 135 persons (67.5%). Statistical analysis showed that significant differences between groups included: lateral shift, SLR test, sensory and motor deficits.Conclusions. 1. Precise analysis showed that among chronic patients with disc disease clinical tests lead to centralisation or peripheralisation of pain. 2. Peripheralisation was statistically more often accompanied with lateral shift, neurological deficits and low results of straight leg raise (SLR) test.
Key words:
chronic pain, Low Back Pain, McKenzie method
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Nerve root tests results for diagnosis and prognosis of the pain syndromes in the lumbar spine area treated under spa conditions

Przemysław Minta, Wiesław Tomaszewski, Monika Sobolak

Przemysław Minta, Wiesław Tomaszewski, Monika Sobolak – Nerve root tests results for diagnosis and prognosis of the pain syndromes in the lumbar spine area treated under spa conditions. Fizjoterapia Polska 2012; 12(1); 21-27

Abstract
Disorders associated with low back pain (lbp) are the result of not only affliction of nerve roots, but also nocireceptive innervated structures of the ligaments and joint capsules. The objective of this study was to determine the prevalence of selected nerve root tests in people selected by the Social Insurance Board (SIB) and the National Health Fund (NHF) for spa treatment due to lbp, and their usefulness for diagnosis and prognosis.The study involved a group of 400 people (200 people recommended by SIB and 200 by the NHF). In questionnaires, beside the basic personal characteristics, the following were taken into consideration: disease duration, pain location and radiation, results of imaging tests, employment status and type of work performed. The questionnaires also carried results of some nerve roots tests carried out. Positive nerve root tests occurred more frequently in people recommended by the SIB for prevention of disability pension award, and their frequency increased with duration of illness and PIT taxable allowance period. SIB patients were recommended for treatment as a result of a disease that was at a more advanced stage than patients from NHF. Analysis of obtained data showed that nerve root tests, in both groups were present in only a quarter of the tested patients, hence this points to their limited diagnostic and prognostic value.
Key words:
Low Back Pain, nerve root tests, spa treatment, prevention of disability pension award
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Strength and kinesthetic differentiation of deep muscles stabilizing lumbar spine in low back subclinical pain complaints

Mirosław Kokosz, Edward Saulicz, Tomasz Wolny, Mariola Saulicz, Andrzej Myśliwiec, Łukasz Gębala, Oliwia Mokrus, Paweł Linek

Mirosław Kokosz, Edward Saulicz, Tomasz Wolny, Mariola Saulicz, Andrzej Myśliwiec, Łukasz Gębala, Oliwia Mokrus, Paweł Linek – Strength and kinesthetic differentiation of deep muscles stabilizing lumbar spine in low back subclinical pain complaints. Part 1. Fizjoterapia Polska 2012; 12(2); 101-112

Abstract
Background. Lumbar spine pain is one of the most frequent malfunctioning of the locomotor system. The aim of this article was to examine whether there is a co-relationship between the preliminary, subclinical symptoms of pain and the strength and kinesthetic differentiation of deep muscles stabilizing the lumbar spine in the lower section of spine. Material and methods. Appearance of pain in lumbar spine was taken as an independent variable. The average intensity of the ailment was 8.81 points (±3.68) in the Oswestry scale in 52 subjects. The second group composed of 48 persons who, at the time of the examination, felt no pain in the low back. Both groups were matched regarding the basic parameters: age, body weigh, height, level of physical activities and sex. Results of tests carried out with the use of pressure stabilizer in the supine and prone positions constituted the dependent variables. Results. Statistical analysis showed that there are significant dependencies between the presence of pain and strength and kinesthetic differentiation in the prone position. No such dependencies were registered in the supine position. Conclusions. Weakness of the deep stabilizing muscles is characteristic for persons with perceived minor lumbar spine pain. The ability to differentiate pressure force is also disturbed. It seems that an examination performed in a prone position is useful in detecting the above changes.
Key words:
Low Back Pain, muscular stabilization, Proprioception
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