Is sustained natural apophyseal glides combined with conventional physiotherapy effective for patients with facet joint syndrome? - a case series

Abstract

BackgroundChronic back pain has been the nemesis of the human race since the time they evolved and began walking on their two legs; leaving aside the 4 limb locomotion of their predecessors. Varied are the causes of low back ache and facet joint syndrome is one amongst them. Hence this study was undertaken to find out the effectiveness of SNAGS and conventional physiotherapy in patients with lumbar facet joint syndrome.PurposeTo describe the management and outcomes of 4 patients with lumbar facet joint syndrome treated with Sustained Natural apophyseal glides (SNAGs), Therapeutic Ultrasound and lumbar stabilization exercises.Study DesignA case series of consecutive patients with Lumbar facet syndromeCase DescriptionFour consecutive patients (mean age 52 years) who presented with lumbar facet syndrome were treated with two weeks protocol which included Sustained Natural apophyseal glides, Therapeutic Ultrasound (Cont. I-MHz, 2.0-W/cm², l0min) and lumbar stabilization exercises. Follow up was taken 1 week after the end of active intervention. All patients completed Visual analogue Scale (VAS), Modified Oswestery Disability Questionnaire (MODQ), Sorensen Test hold Timing and spinal Range of motion on initial assessment, immediately at the end of active intervention (2 weeks) and at the end of follow up.OutcomeAll four patients showed the mean percentage change in score of VAS 49.87%, MODQ 61.14%, Sorensen test scores 19.63%, Flexion range 9.21% and extend range 17.07% at the end of follow up.All four patients with Lumbar facet joint syndrome treated with sustained natural apophyseal glides (SNAGS), Therapeutic Ultrasound and lumbar stabilisation exercises exhibited reduced pain, reduced disability, improved endurance of back muscles and range of motion at the time follow-up.