Oswestry Low Back Pain Disability Research Articles

Comparison of short-wave diathermy, Transcutaneous electrical nerve stimulation of electrotherapy methods and exercise therapy in chronic low back conditions

Background: Low back pain is a significant contributor to global disability, impacting individuals across different age groups. Research suggests that around 80% of people will encounter low back pain at some stage in their lives. This condition is more prevalent among middle-aged and elderly individuals, with a higher occurrence among females. The socioeconomic consequences of low back pain are substantial, including increased healthcare expenses, absenteeism from work, and a diminished quality of life. Objective: To compare the effectiveness of short-wave diathermy with exercise, transcutaneous electrical nerve stimulation with exercise, and exercise alone among patients with chronic low back pain. Patients and Methods: 75 patients who were diagnosed with chronic low back pain, ages 20–50, participated. They were divided into three groups: group A received shortwave with exercise, group B received TENS with exercise, and group C received just exercise. Treatment was given for 12 sessions over a period of 4 weeks. All patients were evaluated before and after treatment using a visual analog scale and the Oswestry Low Back Pain Disability Questionnaire. Results: The results showed that all three interventions were effective in reducing pain and improving physical activities, with varying degrees of success. But also, the result showed that the mean difference for the short wave with exercise is much higher than both the TENS with exercise and the exercise alone types of interventions in each of the different categories, respectively. Conclusion: This study has shown that shortwave exercise is more effective in the treatment of chronic low back pain than TENS with exercise and exercise alone.

Comparison of short-wave diathermy, Transcutaneous electrical nerve stimulation of electrotherapy methods and exercise therapy in chronic low back conditions

Background: Low back pain is a significant contributor to global disability, impacting individuals across different age groups. Research suggests that around 80% of people will encounter low back pain at some stage in their lives. This condition is more prevalent among middle-aged and elderly individuals, with a higher occurrence among females. The socioeconomic consequences of low back pain are substantial, including increased healthcare expenses, absenteeism from work, and a diminished quality of life. Objective: To compare the effectiveness of short-wave diathermy with exercise, transcutaneous electrical nerve stimulation with exercise, and exercise alone among patients with chronic low back pain. Patients and Methods: 75 patients who were diagnosed with chronic low back pain, ages 20–50, participated. They were divided into three groups: group A received shortwave with exercise, group B received TENS with exercise, and group C received just exercise. Treatment was given for 12 sessions over a period of 4 weeks. All patients were evaluated before and after treatment using a visual analog scale and the Oswestry Low Back Pain Disability Questionnaire. Results: The results showed that all three interventions were effective in reducing pain and improving physical activities, with varying degrees of success. But also, the result showed that the mean difference for the short wave with exercise is much higher than both the TENS with exercise and the exercise alone types of interventions in each of the different categories, respectively. Conclusion: This study has shown that shortwave exercise is more effective in the treatment of chronic low back pain than TENS with exercise and exercise alone. Keywords: Shortwave, TENS, Exercise, Chronic low back pain.

Prevalence of Low Back Pain in Pregnant Females

Background: Low back pain (LBP) during pregnancy is a common condition that affects a significant number of women, impacting their daily activities and overall quality of life. Various studies have documented the prevalence and severity of LBP among pregnant women, highlighting the need for more focused healthcare strategies. Objective: The aim of this study was to assess the prevalence, onset, and severity of LBP in pregnant women, and to evaluate the impact of LBP on their daily activities, with a view to enhancing prenatal care and management approaches. Methods: A cross-sectional study was conducted over six months at two hospitals in Lahore, involving 181 pregnant women selected through non-probability convenience sampling. Data were collected using the Oswestry Low Back Pain Disability Questionnaire and the Numeric Pain Index Scale. Statistical analysis was performed using SPSS version 25, focusing on descriptive statistics to calculate means, standard deviations, and prevalence percentages. Ethical considerations followed the Helsinki Declaration guidelines, with informed consent obtained from all participants. Results: The prevalence of LBP among the participants was 76.8%. The pain onset was most frequently reported in the second trimester (38.1% of cases). Severity assessments revealed 36.5% of participants experienced moderate pain and 40.3% severe pain. LBP significantly impaired daily functions, with many women reporting difficulties in walking, sitting, and engaging in other routine activities. Conclusion: LBP is highly prevalent among pregnant women and begins primarily in the second trimester, with a considerable impact on daily activities. This study emphasizes the necessity for routine prenatal assessment and targeted interventions to manage LBP, which could improve pregnancy outcomes and maternal health.

Comparative effects of shockwave therapy and Maitland lumbar mobilization on pain, disability, and range of motion in patients with mechanical low back pain: A pilot study

Objectives: Low back pain (LBP) has been considered a neuromusculoskeletal issue that affects a wide variety of populations around the globe at some stage in their life. This paper aimed to see the comparative effects of shockwave therapy and Maitland lumbar mobilizations on pain severity, disability, and range of motion (ROM) values in subjects with mechanical LBP. Methods: A randomized clinical trial was carried out involving 26 subjects divided into two groups using a random number generator table. After baseline therapy (lumbar stretches and core strengthening exercises), shockwave therapy was administered to Group A (2000 shocks/session, pressure of 2 bars, frequency 10 Hz), while Group B received Maitland lumbar mobilizations (starting from Grade 1, with 3–4 sets of oscillations with 40 counts/set, two sets of oscillation to one level below and above the affected vertebras). Both therapeutic interventions were administered for 30 days, twice a week (total of eight sessions) for individual groups. Results: Numeric pain rating scale, Oswestry LBP disability index, lumbar flexion, and extension ROM pre- and post-treatment values showed significant differences with P < 0.05. A greater difference in mean values was observed in group B receiving Maitland mobilization as compared to group A receiving shockwave therapy. Between-group analysis showed a statistically significant difference in both groups with P < 0.005. Conclusion: Both groups showed significant effects in reducing pain levels, functional disability scores, and improving flexion and extension ROM values. However, participants receiving Maitland mobilization showed more significant improvement in all variables than shockwave therapy.

The analgesic and disability improvement effects of trigger points electroacupuncture on chronic low back pain patients: an uncontrolled before-and-after study

Low back pain (LBP) is the most common cause of disability in patients aged 45 to 65. Traditional medicine plays an important role in the treatment of this disease. Especially, electroacupuncture at 100 Hz is effective in the improvement of pain and symptoms. In addition, clinical and research evidence shows that trigger points acupuncture is effective in LBP treatment. However, these studies have small sample sizes, so their reliability is not high. Thus, our study aims to evaluate the effect of trigger points electroacupuncture (TrP-EA) at 100 Hz on chronic LBP patients with larger sample sizes. 37 patients diagnosed with chronic LBP received TrP-EA at 100 Hz for 4 weeks. Outcome measures were the visual analogue scale (VAS), roland morris questionnaire (RMQ), and Oswestry low back pain disability index (ODI). Compared with the pre-treatment baseline, VAS, RMQ, and ODI improved dramatically after 1 week of treatment (p<0.01), 2 weeks of treatment (p<0.01), 3 weeks of treatment (p<0.01) and 4 weeks of treatment (p<0.01). The results suggest that TrP-EA at 100 Hz had analgesic efficacy and may have the potential to improve disability in patients with chronic LBP.

The analgesic and disability improvement effects of trigger points electroacupuncture on chronic low back pain patients: an uncontrolled before-and-after study

Low back pain (LBP) is the most common cause of disability in patients aged 45 to 65. Traditional medicine plays an important role in the treatment of this disease. Especially, electroacupuncture at 100 Hz is effective in the improvement of pain and symptoms. In addition, clinical and research evidence shows that trigger points acupuncture is effective in LBP treatment. However, these studies have small sample sizes, so their reliability is not high. Thus, our study aims to evaluate the effect of trigger points electroacupuncture (TrP-EA) at 100 Hz on chronic LBP patients with larger sample sizes. 37 patients diagnosed with chronic LBP received TrP-EA at 100 Hz for 4 weeks. Outcome measures were the visual analogue scale (VAS), roland morris questionnaire (RMQ), and Oswestry low back pain disability index (ODI). Compared with the pre-treatment baseline, VAS, RMQ, and ODI improved dramatically after 1 week of treatment (p<0.01), 2 weeks of treatment (p<0.01), 3 weeks of treatment (p<0.01) and 4 weeks of treatment (p<0.01). The results suggest that TrP-EA at 100 Hz had analgesic efficacy and may have the potential to improve disability in patients with chronic LBP.

A PROSPECTIVE COMPARATIVE STUDY ON EFFICACY OF ORAL VITAMIN D FORMULATIONS IN PATIENTS WITH CHRONIC LOW BACK PAIN WITH VITAMIN D DEFICIENCY AT A TERTIARY CARE HOSPITAL

Objective: Chronic low back pain is a global health problem with significant medical and economic burden. Vitamin D deficiency and obesity are its risk factors. The objective was to determine efficacy of oral vitamin D formulations in patients with chronic low back pain with vitamin D deficiency.
 Methods: A prospective analytical cohort study was conducted. Patients with self-reported chronic low back pain and with vitamin D concentrations ≤30 ng/dl were identified and randomized into 3 groups namely Granule, Nano syrup and soft gel capsule group. Vitamin D supplementation of 60,000 IUs per dose for ten consecutive days was given in the form of granule (1 g sachet), Nano syrup (5 ml bottle) and soft gel capsule. We measured (25-hydroxyvitamin D [25(OH)D]) concentrations and to assess pain, Visual analogue scale and Modified Oswestry low back pain disability questionnaire (MODQ) were used before and 12 w after the intervention.
 Results: After 12 w 25(OH)D levels increased significantly with vitamin D supplementation in all the groups but more in the Nano syrup group. There was also significant reduction in back pain intensity in all the groups after vitamin D supplementation. However in Nano syrup group, there was a significantly greater reduction in back pain compared with other groups.
 Conclusion: Our findings suggest that vitamin D supplementation in vitamin D deficient adults may improve chronic low back pain. Hence, testing for vitamin D deficiency in those with chronic low back pain may be warranted.

Comparing the Efficacy of Transforaminal and Caudal Epidural Injections of Calcitonin in Treating Degenerative Spinal Canal Stenosis: A Double-Blind Randomized Clinical Trial

Background: Lumbar spinal stenosis (LSS) is the most common indication for lumbar surgery in elderly patients. Epidural injections of calcitonin are effective in managing LSS. Objectives: This study aimed to compare the efficacy of transforaminal and caudal injections of calcitonin in patients with LSS. Methods: In this double-blind randomized clinical trial, LSS patients were divided into two equal groups (N = 20). The first group received 50 IU (international units) of calcitonin via caudal epidural injection (CEI), and the second group received 50 IU of calcitonin via transforaminal epidural injection (TEI). The Visual Analogue Scale (VAS) and Oswestry Low Back Pain Disability Questionnaire (ODI) were used to assess the patient's pain and ability to stand, respectively. Visual Analogue Scale and ODI scores were recorded and analyzed. Results: The results showed that caudal and TEIs of calcitonin significantly improved pain and ability to stand during follow-up compared to before intervention (P < 0.05). Additionally, CEI of calcitonin after 6 months significantly reduced pain in LSS patients compared to TEI of calcitonin (P < 0.05). However, no significant difference was observed between the two epidural injection techniques in improving the patient's ability to stand (P > 0.05). Conclusions: The results of the study indicate that epidural injection of calcitonin in long-term follow-up (6 months) had a significant effect on improving pain intensity and mobility in patients with LSS, and its effect on pain in the TEI method was significantly greater than that in the CEI method.

Efficacy and Safety of Spinal Collagen Mesotherapy in Patients with Chronic Low Back Pain in a Three-Month Follow-Up—Retrospective Study

Background: Low back pain syndrome is associated with muscular and myofascial pain and is linked with muscle overstrain or a lack of regular physical activity as well as a habitual bad posture, which cause the overload of perispinal soft tissues. One of the forms of therapy of LBP is the mesotherapy of the spine, which consists of multi-point micro-injections of drugs or medicine mixtures, which include preparations of collagen type I. The aim of the study was to assess the efficacy and safety of mesotherapy with collagen type I. Methods: A retrospective analysis of the results of the treatment of patients with chronic low back pain syndrome using mesotherapy was performed. A total of 130 patients (83 women and 47 men; mean age: 51 ± 14 years) were divided into two groups: group I (n = 65), treated with collagen type I, and group II (n = 65), treated with lignocaine 1%. Mesotherapy was performed weekly over five weeks. Patients were assessed using the following scales: the VAS, Laitinen Scale, and Revised Oswestry Low Back Pain Disability Scale before the start of the treatment, after five treatments, and at the three-month follow-up visit. Results: A statistically significant improvement was observed after the use of spinal mesotherapy both with collagen type I and lignocaine, with the collagen treatment having better results at the three-month follow-up visit. No adverse effects were observed after the procedures. Conclusions: Spinal mesotherapy using collagen type I and lignocaine seems to be an effective method in the treatment of chronic LBP. Collagen mesotherapy gives better results in the long term. Mesotherapy is a safe form of therapy.

Percutaneous full-endoscopic transforaminal discectomy versus open microdiscectomy in the treatment of lumbar disc herniation: randomized controlled trial

BackgroundLumbar disc herniation is one of the most common degenerative spine conditions. In our center, the standard surgical technique for treatment of lumbar disc herniation is open microdiscectomy. The full-endoscopic transforaminal discectomy is done for selective cases of lumbar disc herniation under local anesthesia, achieving good results. This study aims to compare the clinical outcomes, operative data, and complications of the treatment of lumbar disc herniation with “percutaneous full-endoscopic transforaminal discectomy” (TED) and the gold standard “open microdiscectomy" (MD). This was a randomized controlled trial that included 65 patients with lumbar disc herniation: 32 in the TED group and 33 in the MD group.ResultsThere was no statistically significant difference between the two groups with regard to the visual analogue scale (VAS) for leg pain, the VAS for back pain, or the Oswestry Low Back Pain Disability Questionnaire (ODI) score at the end of the 1-year follow-up. The operative time in minutes was statistically shorter in the TED group, with a mean value of 50.38 (± 11.65) and 61.09 (± 12.32) in the MD group. The blood loss was 77.33 CC (± 23.14) in the TED group and 170 CC (± 56.06) in the MD group. The mean duration of hospital stay in days was statistically shorter in the TED group. Exposure to radiation in minutes was higher in the TED group: 1.09 (± 0.33) and 0.18 (± 0.08) in the TED group and MD group, respectively. There was no statistically significant difference in the rate of complications.ConclusionTED showed superiority over MD with regard to blood loss, operative time and shorter hospital stays, but with increased radiation exposure. There was no difference in clinical outcomes regarding VAS for leg and back pain and ODI score at 1 year follow-up with no significant difference in complications.

Compare the Effectiveness of Interferential Therapy with Mckenzie Versus TENS With Mckenzie to Reduce Low Back Pain

Background: Low back pain is not an illness but rather a collection of symptoms that are typically acute and selflimiting.It has an impact on work performance and general wellbeing. The most commonly used modalities ofLBP are Interferential therapy and TENS. Hence this research work is done to check the effectiveness of IFT withMcKenzie and TENS with McKenzie for reducing low back pain.Purpose: To compare the effectiveness of IFT and TENS combined with McKenzie to reduce low back pain.Materials and Methods: 60 subjects were selected based on selection criteria.. The subjects were assessed usingVAS and OSWESTRY Low back pain disability questionnaires . The subjects selected were divided into twogroups. IFT group(n=30) received IFT for 20 minutes per day combined with McKenzie exercises TENS group (n=30) received TENS for 20 minutes per day combined with McKenzie exercises. These interventions were given for4 days per week for 2 weeks. Study period: October 2022 to July 2023.Result: The pretest and posttest values were analyzed and results suggest that the IFT group has significantimprovement when compared with the TENS group with p value <0.0001.Conclusion: The study concludes that the IFT with McKenzie and TENS with McKenzie is effective for patientswith low back pain but IFT with McKenzie seems to be more effective than TENS with McKenzie.

Cognitive behavioral therapy (CBT) and meditation in the treatment of persistent low back pain: Interventional Study

Objective: To compare the effect of both CBT and Meditation in chronic lower back pain patients.
 Method: Participants fulfilling the exclusion and inclusion criteria and who are between the age group of 35-50 years with CLBP were included.  Numerical pain rating scale and Montreal Cognitive Assessment (MOCA) was used for the participant selection. The participants were further divided into three groups and 4-week intervention of conventional physiotherapeutic exercise, meditation and CBT, was given to the participants. Numerical Pain Rating Scale and Oswestry Low Back Pain Disability Questionnaire were used as outcome measures.
 Results: 40 chronic back pain patients were enrolled and randomized. All enrolled participants completed baseline tests, providing cross-sectional data for this study. Simple randomization allocated 14 patients to the control group and 13 patients each to Experimental Group 1 and Experimental Group 2. Significant within-group improvements occurred on the Numerical Rating Scale and Oswestry scores between baseline and final visits for all groups. However, the experimental groups showed significantly greater decreases in pain intensity versus controls, evidenced by reduced mean Numerical Rating Scale and Oswestry scores at follow-up. One-way ANOVA and Welch tests revealed significantly reduced Numerical Rating Scale and Oswestry scores after treatment across groups. Both tests yielded statistically significant p-values <0.01.
 Conclusion: The findings show that meditation and cognitive behavioural therapy (CBT) are beneficial in reducing pain. As a result, for patients with persistent low back pain, taking into consideration these two treatment techniques is critical.
 Keywords: Cognitive Behavioural Therapy, Chronic Pain, Oswestry Questionnaire

Prevalence of low back pain and disability among secondary school teacher in the eastern province of the Kingdom of Saudi Arabia: a cross-sectional analytical study.

Lower back pain is common worldwide and affects over 600,000 people annually, including teachers. The study aimed to investigate the prevalence of low back pain and disability among secondary school teachers in the Eastern Province of the Kingdom of Saudi Arabia. This cross-sectional study included secondary school teachers in the eastern province of Saudi Arabia. 34 schools were selected using a multistage stratified sampling approach. Teachers were allotted randomly and proportionally to each school. Data was collected by anonymous questionnaire having three elements: sociodemographic and health-related questions, the Standardized Nordic Questionnaire, and the Oswestry Low Back Pain Disability Questionnaire. The anthropometric data was also included. Both unadjusted and adjusted logistic regression analyses were performed. A total of 601 teachers participated in the study with 62.56% reported low back pain. The overall mean age was 40.31 ± 8.13 years. The male-to-female ratio was similar. Back pain was significantly higher among females than males (73.36 and 51.52%, respectively). Additionally, back pain will significantly increase when stress levels and the number of classes increases. A positive correlation was found between age with low back pain (p = 0.001).There was minimal disability in 64.63% of the 376 teachers who reported low back pain, moderate disability in 29.79%, and severe disability in 4.79%, and only three (0.8%) were considered crippled. Females were more frequently seen in moderate and crippled categories, and perceived stress levels generally increased mean disability scores. Age and female gender were revealed to be significant predictors of low back pain by logistic regression (adjusted odds ratio [OR] = 1.04, 95% confidence interval [CI] = 1.02-1.07) and (adjusted OR = 2.11, 95% CI = 1.45-3.05), respectively. The number of classes per week was also a significant predictor. This study adds to the epidemiological evidence that reveals a high prevalence of low back pain and disability among teachers. Identified risk factors in this study may also reinforce the importance of setting different interventions and preventive measures to reduce lower back pain risk.

Effectiveness of Kinesio-Taping and Conventional Therapy for Non-Specific Chronic Low Back Pain

Chronic non-specific low back pain, which is treated in orthopedic rehabilitation settings, is a frequent musculoskeletal issue. Lumbar spondylosis, Psychogenic Low Back Pain, Spinal Stenosis and poor posture are all causing pain for the patient. Kinesio-Taping helps to reduce or eliminate discomfort.  Objective: To see how effective kinesio-tapping and traditional therapy are for non-specific chronic low back pain. Methods: This was a quasi-experimental study design in which 30 patients were recruited using a convenient sampling sample, with 15 individuals in each group (Group A, Kinesio-Tapping with Conventional Therapy includes stretching, strengthening and hot pack) Group B which consists solely of standard conventional therapy. An independent T-Test for inter-group comparison and a paired sample T-Test for within-group analysis were used to assess the Oswestry Low Back Pain Disability and Numeric Pain Rating Scale. Results: There was a significant change between the baseline and post-treatment NRPS values. Mean difference of 10.42 and 3.14 were reported between the pretreatment and post treatment values of NPRS in KT taping Group which was significant (p-value < 0.05). Mean difference of 14.18 and 3.68 were reported between the pretreatment and post treatment values of NPRS in Conventional PT Program Group which was significant (p-value < 0.05). Conclusions: Kinesio-Taping in conjunction with Conventional Therapy is more effective than Conventional Therapy alone in treating Chronic Non-specific Low Back Pain.

The Influence of Age and Work Experience on Lumbar Spine Pain among the Nursing Staff

Introduction. Currently, back pain syndromes are considered to be widely known problems in the medical, but above all, social and economic aspects. The specific nature of the profession performed by nurses puts them among the people most at risk of spine dysfunction.
 Aim. The aim of this study is to assess the occurrence of pain in the lumbar spine pain among nurses working at the Provincial Specialist Hospital in Włocławek.
 Material and Methods. The research was conducted among 120 nurses working in hospital wards of the Provincial Specialist Hospital in Włocławek. The research used an own survey questionnaire and the Revised Oswestry Low Back Pain Disability Scale (ODI) — the Polish version. Consent to conduct the research was obtained from the Management of the Provincial Specialist Hospital in Włocławek and the Bioethics Committee of the State Academy of Applied Sciences in Włocławek.
 Results. The majority of respondents indicated that they connect back pain with work — 104 people (86.7%) and received the results of slight limitations — 60 people (50.0%). Most respondents indicated that they had experienced pain for 1–5 years — 42 people (35.0%). Respondents aged up to 45 years indicated that they had been experiencing pain for 1–5 years — 15 people (48.4%). In the group with 30–40 years of experience, the most respondents indicated that they had more than 10 years of experience — 19 people (34.5%). In the group with 30–40 years of experience, the majority indicated that often several times a month — 21 people (38.2%). The highest degree of disability was recorded at the age of 56–62, serious disruptions — 8 people (33.3%), and at the age of 51–55, serious disruptions — 6 people (14.03%).
 Conclusions. The work performed affects the occurrence of pain in the lumbar spine. Age groups up to 45 years and 46–50 years have been experiencing pain for 5–10 years. Pain is most often experienced by respondents with 30–40 years of work experience. The vast majority of respondents experience slight limitations. The highest rate of disability is experienced by nurses aged 51–55. (JNNN 2023;12(4):164–169)

Primary osteoarthritis of the lumbar spine presenting as chronic low back pain or sciatica or both (prolapsed lumber disc syndrome): establishing its cause, pathogenesis, and treatment: A randomized case-control study

: The objectives of this study were to compare three scores, Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), Oswestry Disability Index (ODI) for low back pain, and Visual Analogue Scale (VAS) Vertical Version at the beginning and end point in two, Trial (G1), and Control (G2) groups of Primary Osteoarthritis of lumbar spine patients.The inner nucleus pulposus may rupture out from the annulus as the disc continues to degrade or as the spine continues to be stressed. This is a herniated or burst disc. The nerve roots that are immediately behind the disc space may then be pressed by the disc material fragments. This may result in discomfort, frailty, numbness, or alterations in feeling.: Understanding the causes, pathophysiology, and treatments for prolapsed lumber disc syndrome, which presents as primary osteoarthritis of the lumbar spine and causes chronic low back pain, sciatica, or both.: In this study, the total number of patients were 150, in G1 - 100, and G2 - 50. G1 received the hypothesized treatment, Contracture Correction Therapy (CCT), while G2 did “No Therapy”. WOMAC determination was done by the questionnaire; ODI by modified Oswestry Low Back pain disability questionnaire and VAS by Visual Analogue Scale Vertical Version, all at 0, 6, 12, and 24 weeks. The CCT consisted of 1. Immobilization of the spine. 2. Passive and active extension of the spine. 3. Three therapeutic rituals and 4. Advice to avoid stooping.: The CCT receiving was associated with much recovery (P <0.00) while non-receiving with much less (P =0.00). In G1 WOMAC decreased from 54.29 to 0.00; ODI from 51.82 to 1.80; VAS rose from 37.56 to 100 (rise indicates betterment) P= 0.00. In G2 WOMAC lowered from 56.40 to 4.08; ODI from 65.10 to 6.0; VAS rose from 34.40 to 81.00. Relief in symptoms was similar.: The cause, pathogenesis, and treatment are deficient full extension, I.V. joint capsule contracture formation, and extension of the lumbar spine respectively.

Prevalence of Low Back Pain Among University Attendants in Tabuk City During 2023: A Cross-Sectional Study in Saudi Arabia.

College students are at a higher risk of suffering low back pain (LBP). Assessing the magnitude of the problem and the associated risk factors can help reduce the suffering and disability in future doctors. This study was conducted to investigate the prevalence and related factors of LBP among medical students in the University of Tabuk and emphasize the need for targeted interventions that could help alleviate the burden of LBP among the students and improve their quality of life. This cross-sectional study used an online well-structured, self-report questionnaire to collect the respondents' data. The questionnaire explored the participants' sociodemographic factors, lifestyle, and the severity of LBP-related disability using the modified Oswestry Low Back Pain Disability Questionnaire (Oswestry Disability Index (ODI)) score. The prevalence rate of LBP was 26.8%. The independent factors that significantly increased the probability of LBP included overweight/obesity (odds ratio (OR): 1.696, 95% confidence interval (CI): 1.086 to 2.648, p = 0.020) and stretching exercises (OR: 1.784, 95% CI: 1.104 to 2.883, p = 0.018). The independent predictors that significantly increased the severity of ODI included married marital status (p = 0.007), back surgery (p = 0.031), and higher pain intensity (p < 0.001). We found that the prevalence rate of LBP among our sample was around 26%. This rate is approximate to the rates reported in previous studies. Furthermore, the activities most affected by LBP were sitting, standing, and lifting. Future studies should explore other risk factors and attempt to determine the onset of pain. A longitudinal study design is recommended to identify the onset of developing LBP.

Prevalence of Low Back Pain and Its Related Risk Factors and Disability Following Lumbar Discectomy: A Single-Center Study.

Background Lumbar disc herniation is considered the most common cause of sciatica, which is a contributing factor to disability. Surgical management of lumbar disc herniation in the form of discectomy is superior to conservative management in terms of better recovery and pain relief. However, recurrence, residual back pain, and disability are common expected complications following surgery. Therefore, this study aims to determine the prevalence of low back pain and its related risk factors and disability following discectomy at King Fahad Hospital in the Al-Ahsa region. Methodology A cross-sectional study was conducted at King Fahad Hofuf Hospital in the Al-Ahsa region among patients who were admitted and underwent lumbar spine discectomy in the last six years either due to traumatic or degenerative causes. The study used an anonymous questionnaire consisting of the patient's sociodemographic data, medical and surgical history, spine disease history, and surgical history. The preoperative Glasgow Coma Scale score, neurological status, and American Spinal Cord Impairment Scale score were noted. In addition, immediate postoperative neurological status and minor complications were recorded. Moreover, more than six months postoperatively, the Numeric Analogue Scale and the Oswestry low back pain disability index questionnaire were administered. Results A total of 201 patients were included in the study. The majority of the patients were male (59.7%), with ages ranging from 41 to 60 years (51.7). Most patients underwent one surgery (83.6%) in the form of discectomy alone (90.5%) at L3-L4 (58.7%), for which the intervertebral disc was the most common degenerative indication for surgery. All patients (100%) had low back pain preoperatively, and most patients (50.7%) had no back pain six months postoperatively. Preoperatively, 58.2% had diminished neurological status, while only 29.9% showed a deficit postoperatively. Postoperative low back pain was significantly associated with office-based jobs (p = 0.021, 60.5%) and a high number of surgeries (p = 0.004, 74.1%). The following factors were observed to be risk factors for having lower back pain: six months postoperatively, being unemployed (p = 0.024, odds ratio = 4.38, 338% increased risk), having an office-based job (p = 0.012, odds ratio = 3.98, 298% increased risk), and the underlying cause of the problem being degenerative (p = 0.003, odds ratio = 3.34, 234% increased risk). Low back pain-related severe disability postoperatively was significantly associated with increased age >40 (28-50%; p = 0.045), female gender (p = 0.012, 44.4%), and being unemployed (p = 0.002, 51.4%). The level of disability six months postoperatively was moderate in 40.4% of the patients. Conclusions Lumbar discectomy is a successful procedure for relieving low back pain among patients with degenerative spine disease, with an improvement that involves neurological status. However, residual back pain may still occur in less than half of the patients despite appropriate management, such as being unemployed or office-based employees and having multiple spine surgeries. However, low back pain-related disability is often moderate, with increasing severity seen with increased age, being female, and being unemployed.

Efficacy of conditioned autologous serum therapy (Orthokine®) on the dorsal root ganglion in patients with chronic radiculalgia: study protocol for a prospective randomized placebo-controlled double-blind clinical trial (RADISAC trial)

BackgroundPulsed radiofrequency (PRF) treatment on the dorsal root ganglion (DRG) has been proposed as a good option for the treatment of persistent radicular pain based on its effect of neuromodulation on neuropathic pain. Autologous conditioned serum (ACS) therapy is a conservative treatment based on the patient’s own blood. The aim of this manuscript is to develop a study protocol using ACS on the DRG as a target for its molecular modulation.MethodsWe plan to conduct a randomized controlled study to compare the efficacy of PRF therapy plus ACS versus PRF therapy plus physiological saline 0.9% (PhS) on the DRG to reduce neuropathic pain in patients with persistent lower limb radiculalgia (LLR) and to contribute to the functional improvement and quality of life of these patients.Study participants will include patients who meet study the inclusion/exclusion criteria. Eligible patients will be randomized in a 1:1 ratio to one of treatment with PRF plus ACS (experimental group) or PRF plus PhS (placebo group). The study group will consist of 70 patients (35 per group) who have experienced radicular pain symptoms for ≥ 6 months’ duration who have failed to respond to any therapy. Both groups will receive PRF on the DRG treatment before the injection of the sample (control or placebo). Patient assessments will occur at baseline, 1 month, 3 months, 6 months, and 12 months after therapy.The primary efficacy outcome measure is Numeric Pain Rating Scale (NPRS) responders from baseline to 12 months of follow-up using validated minimal important change (MIC) thresholds. A reduction of ≥ 2 points in NPRS is considered a clinically significant pain relief.The secondary efficacy outcome measure is the proportion of Oswestry Low Back Pain Disability Scale (ODS) responders from baseline to 12 months of follow-up in the experimental group (PRF plus ACS) versus the placebo group (PRF plus PhS). ODS responders are defined as those patients achieving the validated MIC of ≥ 10-point improvement in ODS from baseline to 12 months of follow-up as a clinically significant efficacy threshold.DiscussionThis prospective, double-blind, randomized placebo-controlled study will provide level I evidence of the safety and effectiveness of ACS on neuropathic symptoms in LLR patients.Trial registration {2a}{2b}EUDRACT number: 2021–005124-38. Validation date: 13 November 2021. Protocol version {3}: This manuscript presents the 2nd protocol version.

Conservative Treatments of Adolescent Idiopathic Scoliosis: Physical Therapists' Perspectives.

This study aimed to examine physical therapists' perspectives in conservative treatments of pediatric patients with adolescent idiopathic scoliosis (AIS). A cross-sectional survey design was used. A validated questionnaire was distributed to physical therapists, and the responses were analyzed. Preferred treatment frequency was 60 minutes (53.8%), twice weekly (41.5%), over 3 to 5 months (44.6%). Top 3 clinical interventions were core and trunk stability enhancement (90.8%), abdominal strengthening (83.1%), and postural correction (80.0%). Top 3 therapeutic goal-setting parameters were activity-based (78.5%), quality-of-life measure-based (56.9%), and participation-based (50.8%). The most common quality-of-life survey used was Oswestry low back pain disability questionnaire (15.6%) followed by Scoliosis Research Society-22 instrument (12.5%). According to our data, physical therapists believe that pediatric patients with AIS can benefit with addressing core and trunk stability, a 60-minute per session, twice weekly, over 3 to 5 months based on activity-based goal-setting and quality-of-life measures using Oswestry questionnaire.