Abstract

Back Ground: Sciatica is a frequent clinical illness that may be intensely painful, disabling, and life-altering.
 Objectives: The goal of this research was to see how high-power laser therapy affects the intensity of pain, angle of straight leg raise, six-minute walk test and electrophysiological studies in patients with chronic discogenic sciatica.
 Methods: A lumbar disc herniation at L5-S1 caused chronic unilateral sciatica in thirty-six male patients were included in this study. The patients have been divided into 2 identical groups [the control group (G1) and the study group (G2)] randomly. Participants in the control group (G1) got a designed physiotherapy program that included ultrasound, stretching exercise, back muscles strengthening exercise and sciatic nerve flossing technique. While patients in the study group (G2) got the same designed physiotherapy program as G1 plus high power laser therapy (HPLT). The outcome measures were latency and amplitude of Hoffmann reflex (H-reflex) for evaluating S1 nerve root function, visual analog scale (VAS) for evaluating pain level, angle of straight leg raise (SLR) and six-minute walk test (6MWT) for assessing functional impairment. Both groups were assessed before and after 4 weeks of therapy.
 Results: The findings demonstrated that both groups showed a significant reduction in pain level and latency of H-reflex following therapy. The angle of SLR, 6-minute walking distance (6MWD), and the amplitude of the H-reflex all improved significantly in both groups. After therapy, the study group's VAS and H reflex latency were significantly decreased than the control group's (p < 0.01). In addition, the study group's 6MWD, angle of SLR, and H reflex amplitudes were significantly increased than the control group's (p < 0.01) following therapy. 
 Conclusion: High power laser therapy (HPLT) is a successful treatment for patients suffering from chronic discogenic sciatica.

Highlights

  • Sciatica is a radicular leg pain that is localized to the dermatome of a pathologically affected nerve root

  • The study group's visual analog scale (VAS) and H reflex latency were significantly decreased than the control group's (p < 0.01)

  • The study group's 6-minute walking distance (6MWD), angle of straight leg raise (SLR), and H reflex amplitudes were significantly increased than the control group's (p < 0.01) following therapy

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Summary

Introduction

Sciatica is a radicular leg pain that is localized to the dermatome of a pathologically affected nerve root. Discogenic sciatica is caused by lumbar disc herniation (LDH), which can lead to neurological dysfunctions like leg paresthesia, disability, leg pain, and low back pain [1,2]. When the nerve is compressed, tense, or sheared beyond its capacity, the circulation and axoplasmic flow within the nerve are impeded, resulting in ischemia and lowered function [5, 6]. Compressive stress is caused by disc herniations, which obstruct blood supply to the nerve root [7]. Nerve root compression causes alterations in the nerve's microvascular circulation as well as the release of inflammatory mediators, resulting in pain [10]. Nerve root compression is linked to neural conduction block and intraneural edema [11, 12]

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