The analgesis effectiveness of continuous and fractionated doses of laser radiation in the rehabilitation of patients with chronic pain syndrome in the lumbo-sacral spine

Jolanta Kujawa, Anna Cink, Kamila Gowrys, Ireneusz Pieszyński, Jan Talar

Jolanta Kujawa, Anna Cink, Kamila Gowrys, Ireneusz Pieszyński, Jan Talar – The analgesis effectiveness of continuous and fractionated doses of laser radiation in the rehabilitation of patients with chronic pain syndrome in the lumbo-sacral spine. Fizjoterapia Polska 2004; 4(3); 237-244

Abstract

Background. Due to the complex etiopathogenesis and the diversity of treatment approaches, spinal pain syndromes constitute a serious medical problem. The chronic pain and functional disturbances accompanying discopathy have motivated a search for more effective physiotherapeutic methods, such as McKenzie’s method of biomechanical diagnosis and treatment and laser therapy. The goal of the present study was to evaluate the analgesic effectiveness of continuous and fractionated doses of laser radiation in chronic lumbo-sacral pain syndrome. Material and methods. Our research involved 88 patients with chronic spinal pain syndrome qualified for McKenzie kinesitherapy. All subjects received kinesitherapy according to the authors’ method, selected according to the biomechanical diagnosis, along with 10 laser therapy procedures. Group A (43 patients) received a continuous dose of 9 J per point, while Group B (45 patients) received a fractionated dose of 3J + 6J per point. 37 points in the lumbo-sacral region were irradiated. Results. Group B showed a significantly greater decrease in pain intensity on the VAS scale (0-10 points), and in pain frequency. Both groups were found to have a reduced deficit in range of movement according to the McKenzie Institute lumbar checklist. Conclusions. Laser therapy with fractionated doses proved to be more effective in pain relief than continuous doses. The method of dosing laser radiation had no effect on improved range of movement in the lumbar spine. Biomechanical treatment using the McKenzie method combined with laser therapy significantly reduces pain and improves the range of movement in patients with chronic lumbar pain syndrome.

Key words:
discopathy, McKenzie method, kinesitherapy, biomechanical diagnostics
Invalid download ID. Pobierz bezpłatnie artykuł w j. angielskim

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
Invalid download ID. Pobierz bezpłatnie artykuł w j. angielskim