Conservative Management of Acute Lumbar Disc Herniation

Abstract

Background: Low back pain (LBP) due to acute disc herniation is a common disease bellow the age 45 years of age. Nowadays several types of treatment modalities used to manage these patients. The economic burden of LBP is heavy. LBP rank fifth among category of diseases in cost of hospital care. LBP has higher indirect costs due to absenteeism from work and disability than any other disease. This study was performed to assess the clinical outcomes of non-surgically treatment of LBP patients after six months follow up. Material & methods: Present prospective study was performed among 50 lumbar radicular patients with clinical signs and symptoms of acute lumbar disc herniation (less than three months). Their diagnosis was confirmed by Magnetic Resonance Imaging (MRI) study. The patties were treated conservatively during six months. Study outcome variables were pain and disability that were assessed by Visual Analog Scale (VAS) and Oswestry Disability Questionnaire (ODQ). Results: Twenty (40%) female and 30 (60%) male were participated in the study. During the follow up period, five (10%) patients (four male) were referred to neurosurgeon due to poor response to conservative treatment and motor weakness. Pain of patients according to VAS after six months conservative treatment significantly improved than initial evaluation of patients (3.11 ± 1.83, 7.1 ± 1.43 P = 0.00). Disability score of patients significantly improved with conservative treatment in follow up period (25.82 ± 16.92, 53.66 ± 17.66; P = 0.00). Conclusion: Results of our study showed that conservative treatment in patients with acute lumbar disc herniation causes significant pain relief and disability improvement without any notable side effect.