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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The impact of laser biostimulation combined with diclofenac inunction on treatment outcome in patient with gonarthrosis

Jolanta Kujawa, Jan Talar, Kamila Gworys, Przemysław Gworys, Jarosław Oborzyński, Ireneusz Pieszyński, Mirosław Janiszewski

Jolanta Kujawa, Jan Talar, Kamila Gworys, Przemysław Gworys, Jarosław Oborzyński, Ireneusz Pieszyński, Mirosław Janiszewski – The impact of laser biostimulation combined with diclofenac inunction on treatment outcome in patient with gonarthrosis. Fizjoterapia Polska 2004; 4(3); 185-193

Abstract

Background. In patients with chronic knee pain and degenerative gonarthrosis, a wide range of physical agents are used, along with local application of non-steroid anti-inflammatory and analgesic drugs in gel or cream form. The evaluation of the clinical and functional status associated with changes in muscle tension and blood flow in the knee region can be facilitated by thermovisual tests, which measure the intensity of infrared radiation to determine skin temperature differences. Material and methods. 99 successive patients diagnosed with gonarthrosis and knee pain persisting > 6 weeks were enrolled. All patients were randomly assigned to one of three groups: Group A (n=32), who received laser biostimulation; Group B (n=35), who received the same laser procedures, and were also instructed to use sodium diclofenac (Voltaren gel) as an inunction on the affected joint; and Group C (n=32), a comparison group. We evaluated pain intensity using the VAS scale, and measured temperature distribution with thermograms performed twice in all patients, before and after treatment. Results. Significant reductions in pain intensity and frequency were observed in groups A and B, but Group B showed significantly greater improvement. In both experimental groups, thermograms showed normalization of temperature distribution. Conclusions. An improper temperature distribution along the lower extremity and around the patella was observed in patients with knee pain syndrome. The application of laser biostimulation in gonarthrosis produces temperature normalization in the irradiated tissues and reduced pain symptoms, which was more pronounced when combined with externally applied sodium diclofenac gel.

Key words:
low intensity laser therapy, thermovision, Pain Management
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