Predetermined physical factors and alternative factors in the treatment of chronic pain in discogenic lumbosacral radiculitis

Abstract

Objectives: Evolution of acute pain in discogenic lumbosacral radiculopathy to subacute and chronic pain reflects pharmacotherapeutic issues and even helplessness in some cases. It has social significance since 80% of people in working age have faced it at least once in their working lifetime. Most of the acute and subacute (> 6 weeks) episodes resolve within 3 months while in 10–15% of patients their condition does not resolve and they develop chronic (> 3 months) lumbosacral syndrome. Material and methods: We present our experience in non-pharmaceutical treatment of chronic pain in discogenic lumbosacral radiculopathy after comparison of different predetermined and alternative therapies that have been given to patients who were selected by highly informative assessment indicators for the extent of spinal root lesion. Sixty patients were enrolled in this study and were divided into two groups of 30 patients each. The first group was treated with classic acupuncture, and the second group with two predetermined factors from conventional physiotherapy. The effect of the two treatments applied was followed up after each procedure in the therapeutic course, and also a month later. Results: As a result of the obtained statistical data, we present a variant of non-invasive treatment of chronic pain that would be useful in clinical practice. Conclusions: In cases of chronic pain in this particular disease, a recommendation should be given for the combination of two physical factors – paravertebral application of ultrasound in impulse mode with an appropriate anti-inflammatory medicament as a mediator in the area of the lumbosacral spine segment, by a labile method, combined with low frequency impulse magnet field in the low back area and the affected leg. Also, acupuncture could be used in fighting against pain, especially in patients contraindicated for predetermined factors (those with a pacemaker, or an oncological process in the small pelvis area).