Intervertebral Disk Displacement, Radiculopathy, Sciatic Neuropathy
Conditions
Keywords
sciatic neuropathy, physical therapy, spinal injections
Brief summary
The purpose of this study is to determine if participation in physical therapy in conjunction with a selective nerve root block in the lumbar spine is more effective than just receiving the injection alone for patients with low back and leg pain from a disk herniation (sciatica).
Detailed description
Recent reviews report moderate to strong evidence for short-term relief but limited evidence for long-term improvement. Anecdotal reports and case studies suggest good outcomes with various physical therapy interventions however well-designed research studies examining treatments in combination are lacking. The management of lumbar radicular pain often includes the combination of physical therapy and therapeutic selective nerve root blocks with the rationale that reducing inflammation and pain will permit greater participation in physical therapy. The effectiveness of this combination of treatment has not been studied and is the purpose of this pilot study.
Interventions
OTHERLumbar injection
Patients are instructed to resume normal activity as tolerated.
OTHERRehabilitation following lumbar injection
Participants are referred to an average of four weeks of physical therapy after receiving a lumbar injection. Physical therapy designed to include end-range directional preference exercises and/or mechanical traction to reduce lower extremity symptoms and progress activity tolerance.
Sponsors
University of Utah
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* MRI evidence of disk herniation in the lumbar spine consistent with clinical presentation * Pain and/or paresthesia in the lumbar spine and a distribution extending distal to the gluteal fold within 24 hours of enrollment * Scheduled to receive a therapeutic selective nerve root block
Exclusion criteria
* Any lumbar surgery within six months of the baseline examination * Any prior lumbar surgery involving fusion * Medical red flags indicating a serious pathology such as neoplasm, infection, or fracture
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Modified Oswestry Disability Index | Baseline (pre-injection), 8 weeks (post-injection), 6 months post-injection |
Secondary
| Measure | Time frame |
|---|---|
| Global Rating of Change | 8 weeks (post-injection) and 6 months (post-injection) |
Countries
United States
Outcome results
None listed