Lumbar Disc Herniation
Conditions
Keywords
Low back pain, Disc herniation, Strengthening exercise, ADL instructions
Brief summary
Lumbar disc herniation (LDH) is one of the most common causes of mechanical low back pain (LBP) associated with radiating leg pain. Conservative treatment, including exercise, analgesic, and physical therapy, is regarded as the first-line treatment of LDH. This randomized clinical trial was conducted to evaluate the effectiveness of back and hip strengthening exercises combined with activities of daily living instructions (ADLIs) to reduce pain intensity in patients with LDH.
Detailed description
A total of 70 patients with LDH were randomly allocated to either the intervention group (IG) or the control group (CG). Patients in IG received different back and hip strengthening exercises five days a week for six weeks. The patients in CG were treated with Naproxen (500 mg) and Baclofen (10 mg) tablet twice a day for three weeks, followed by hot moist compression for the next three weeks. In addition, the patients in both groups were instructed to follow the ADLIs during the intervention and at least 3 months after the intervention. The straight leg raising (SLR) test and the Visual Analogue Scale (VAS) score were used to evaluate the patients' pain intensity. Outcomes were measured at baseline, at three weeks, and six weeks of the intervention. Patients were followed up after 3 months of the intervention.
Interventions
Back and hip strengthening exercises. The intensity of exercises was based on the exercise tolerance and pain thresholds of the individual subjects.
Naproxen (500 mg) and Baclofen (10 mg) tablet twice a day for three weeks
OTHERHot compression
Hot moist compression from week 4 to week 6.
BEHAVIORALActivities to daily living instructions
* Avoid forward bending. * Avoid heavy weightlifting. * Avoid prolong standing. * Avoid prolong sitting. * Use a plain firm bed. * Lie down in a supine position.
Sponsors
Chittagong Medical College
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 59 Years
Healthy volunteers
No
Inclusion criteria
* Age: 18 - 59 years. * Clinically diagnosed LDH that was confirmed by MRI. * Duration of the pain: ≥ 3 months
Exclusion criteria
* Painful spinal deformity * Cauda equina syndrome * Progressive neurological signs and/or muscle-wasting * History of spinal surgery, spine fracture, scoliosis, tuberculosis, and tumours. * Treated with epidural injections. * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in perceived pain intensity | Outcomes were evaluated at baseline, at three weeks, and six weeks of the intervention. Patients were followed up after 3 months of the intervention. | Visual analog scale (VAS) score: Patients were asked to rate their perceived pain on a 0-to-10-point scale, where 0 indicated no pain at all and 10 indicated the most severe imaginable pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in the range of hip flexion during straight leg raising test | Outcomes were evaluated at baseline, at three weeks, and six weeks of the intervention. Patients were followed up after 3 months of the intervention. | The range of hip flexion during affected and unaffected straight leg raising without pain was measured by hand-held goniometry. |
Countries
Bangladesh
Outcome results
None listed