How effective is a multimodal physical rehabilitation protocol in patients advised surgery for chronic lumbar radicular pain? A retrospective analysis of 189 patients with a minimum follow-up of 1 year

Abstract

Background The purpose of this study was to determine the effectiveness of a multi-modal physical rehabilitation protocol (MPRP) in reducing pain and disability and preventing surgery in patients with chronic lumbar radicular pain (LRP) at a minimum follow-up of 12 months. Methods Pre and post-treatment NPRS score, ODI score, disability categories of 189 patients with chronic LRP treated with MPRP were analysed to determine the efficacy of the treatment. Patients were followed-up at a minimum duration of 12 months for pain, disability, surgery performed, and patient satisfaction with treatment. Results After a mean treatment of 59 days, there was significant reduction in mean NPRS (p < 0.0001) and mean ODI (p < 0.0001) scores. Of 89 patients (47%) who could be contacted at mean follow-up of 18 months, 9 patients (10%) had undergone lumbar surgery, 52 patients (58.5%) reported no pain or complaints related to their lower back and 66 patients (74%) were either very satisfied or satisfied with the outcome of their treatment. Conclusions A MPRP is effective in significantly improving pain and disability in patients advised surgery for chronic LRP. At a minimum follow-up of 12 months, pain and disability continued to be significantly lower and only 10% (9/89) patients underwent lumbar surgery.