Intervertebral disc disorders are a common cause of low back pain, with overt disc herniations affecting 2-3% of the population at any given time (remember, many more will have discogenic pain arising from some form of disc pathology without frank herniation!). Current evidence has demonstrated that first-line conservative management such as analgesic medications, steroid injections and physical/manual therapy, within 12 weeks of symptom onset, results in symptomatic relief in over 90% of patients. However, the cost of prolonged use of nonoperative treatments in patients not experiencing early clinical improvement is unclear.
The aim of this cross-sectional cohort study is to compare the utilization of conservative treatments (including chiropractic) used in lumbar intervertebral disc herniation patients who were successfully treated nonoperatively versus patients who were unsuccessfully treated nonoperatively, resulting in elective microdiscectomy surgery. Some big, promising data, but we have to take into consideration some of the limitations of this type of research - read or listen to the Review for more…LOG IN OR SUBSCRIBE TO ACCESS THIS REVIEW!
THIS WEEK'S RESEARCH REVIEW: "Nonoperative Management Strategies in Lumbar Disc Herniation”
This paper was published in the Global Spine Journal (2020) and this Review is posted in Recent Reviews, Lumbar Spine - Disc & Neurological and the 2020 Archive.
Preview: The studied population consisted of 277 941 adult patients diagnosed with a lumbar disc herniation.
"Research has demonstrated that conservative therapies can play an important and successful role in the first-line management of lumbar disc herniation patients. This paper demonstrated that 97% of patients can successfully be treated with nonoperative management, which supports past research and this premise."