Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 5 Issue 6

Which is a more Efficacy Method between Manual Therapy, Traction, or Laser in Low Back Pain without Neurological Deficiency? A Randomized Controlled Trial

Piotr Godek* and Wojciech Rucinski

Sutherland Medical Center, Warsaw, Poland

*Corresponding Author: Piotr Godek, Sutherland Medical Center, Warsaw, Poland.

Received: April 06, 2022; Published: May 20, 2022

Abstract

Background: The conservative treatment of Low Back Pain (LBP) is the generally accepted standard of care at least in its initial phase. A myriad of modalities are offered but optimal management is still a matter of debate.

Objective: Efficacy comparison of selected methods of conservative LBP treatment.

Methods: Ninety patients with LBP were allocated randomly to three groups each containing 30 participants with a different method of treatment. Manual therapy (MT), Traction Therapy (TT), or High-Intensity Laser (HIL) were implemented twice a week for five weeks. Assessment: Baseline (T0), 4 (T1), and 12 (T2) weeks after last intervention. Primary outcomes: Visual Analogue Scale (VAS, 0-10), Oswestry Disability Index (ODI, 0-50), Modified Laitinen Questionnaire (MLQ, 0-16). Secondary outcomes: Seat and reach test (SaR) and range of motion (ROM).

Results: No significant statistical differences (SSD) between groups for primary outcomes at T1. At T2 noted SSD in ODI for HIL (12.27) versus MT and TT (6.87, 7.03 respectively), p = 0,002. In all groups, SaR and ROMs directions improved at T1, but during follow-up, only side-bending right was maintained.

Conclusions: MT, TT, and HIL are comparable methods in terms of efficacy for LBP treatment.

 

Keywords: Low Back Pain; Conservative Treatment; Rehabilitation; Physical Therapy Modalities; Laser Therapy

References

  1. Hoy D., et al. “The Epidemiology of low back pain”. Best Practice and Research: Clinical Rheumatology 6 (2010): 769-781.
  2. Meucci RD., et al. “Prevalence of chronic low back pain: systematic review”. Revista de Saúde Pública 49 (2015):
  3. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. “Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016”. Lancet10100 (2017): 1211-1259.
  4. Zaina F., et al. “Surgical versus non-surgical treatment for lumbar spinal stenosis”. Cochrane Database of Systematic Reviews 1 (2016): CD010264.
  5. Olmarker K., et al. “Autologous nucleus pulposus induces neurophysiologic and histologic changes in porcine cauda equina nerve roots”. Spine (Phila Pa 1976)11 (1993): 1425-1432.
  6. Olmarker K and Rydevik B. “Selective inhibition of tumour necrosis factor-alpha prevents nucleus pulposus-induced thrombus formation, intraneural edema, and reduction of nerve conduction velocity: possible implications for future pharmacologic treatment strategies of sciatica”. Spine (Phila Pa 1976)8 (2001): 863-869.
  7. Takahashi N., et al. “Pathomechanisms of nerve root injury caused by disc herniation: an experimental study of mechanical compression and chemical irritation”. Spine (Phila Pa 1976) 5 (2003): 435-441.
  8. Chou R., et al. “Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society”. Annals of Internal Medicine 7 (2007): 478-491.
  9. Coulter ID., et al. “Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis”. The Spine Journal 5 (2018): 866-879.
  10. Krekoukias G., et al. “Spinal mobilization vs conventional physiotherapy in the management of chronic low back pain due to spinal disk degeneration: a randomized controlled trial”. Journal of Manual and Manipulative Therapy 2 (2017): 66-73.
  11. Aure OF., et al. “Manual therapy and exercise therapy in patients with chronic low back pain: a randomized, controlled trial with 1-year follow-up”. Spine (Phila Pa 1976)6 (2003): 525-531.
  12. Assendelft WJ., et al. “Spinal manipulative therapy for low back pain. A meta-analysis of effectiveness relative to other therapies”. Annals of Internal Medicine 11 (2003): 871-881.
  13. Clarke JA., et al. “Traction for low-back pain with or without sciatica”. Cochrane Database of Systematic Reviews 4 (2005):
  14. Wegner I., et al. “Traction for low-back pain with or without sciatica”. Cochrane Database of Systematic Reviews 8 (2013): CD003010.
  15. Clarke J., et al. “Traction for low back pain with or without sciatica: an updated systematic review within the framework of the Cochrane collaboration”. Spine (Phila Pa 1976)14 (2006): 1591-1599.
  16. Alrwaily M., et al. “Assessment of variability in traction interventions for patients with low back pain: a systematic review”. Chiropractic and Manual Therapies 26 (2018):
  17. Fulop AM., et al. “A meta-analysis of the efficacy of laser phototherapy on pain relief”. The Clinical Journal of Pain 8 (2010): 729-736.
  18. Bjordal JM., et al. “A systematic review of low-level laser therapy with location-specific doses for pain from chronic joint disorders”. Australian Journal of Physiotherapy 2 (2003): 107-116.
  19. Yousefi-Nooraie R., et al. “Low-level laser therapy for nonspecific low-back pain”. Cochrane Database of Systematic Reviews 2 (2008):
  20. Glazov G., et al. “Low-level laser therapy for chronic non-specific low back pain: a meta-analysis of randomized controlled trials”. Acupuncture in Medicine 5 (2016): 328-341.
  21. Gocevska M., et al. “Effects of High-Intensity Laser in Treatment of Patients with Chronic Low Back Pain”. Open Access Macedonian Journal of Medical Sciences 6 (2019): 949-954.
  22. Alayat MS., et al. “Long-term effect of high-intensity laser therapy in the treatment of patients with chronic low back pain: a randomized blinded placebo-controlled trial”. Lasers in Medical Science 3 (2014): 1065-1073.
  23. Alayat MSM., et al. “The effectiveness of high-intensity laser therapy in the management of spinal disorders: A systematic review and meta-analysis”. Journal of Back and Musculoskeletal Rehabilitation 6 (2019): 869-884.

Citation

Citation: Piotr Godek and Wojciech Rucinski. “Which is a more Efficacy Method between Manual Therapy, Traction, or Laser in Low Back Pain without Neurological Deficiency? A Randomized Controlled Trial". Acta Scientific Orthopaedics 5.6 (2022): 66-74.

Copyright

Copyright: © 2022 Piotr Godek and Wojciech Rucinski. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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