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Pain Management 2019 & Internal Medicine 2019
March 25-26, 2019
Rome, Italy
International Journal of Anesthesiology & Pain Medicine
ISSN: 2471-982X
Page 21
JOINT EVENT
7
th
Edition of International Conference on
Pain Management
8
th
Edition of International Conference on
Internal Medicine &
Patient Care
&
Interdisciplinary approach towards
analgesia in low back pain and
lumbo-sacral radiculopathy: Impact of
paravertebral infiltrations, laser therapy
and deep oscillation (a comparative
study of five rehabilitation complexes)
Ivet B Koleva
Medical University of Sofia, Bulgaria
Thegoalofcurrentworkistocomparetheimpactofdrug
therapy versus different pre-formed physical modalities
in the complex rehabilitation algorithm of patients with
back pain. We observed a total of 455 patients with low
back pain and lumbo-sacral radiculopathy; randomized
into five therapeutic groups (of 91 patients each one).
In all patients we applied a complex physiotherapy
programme, including analytic exercises; soft tissue
techniques (post-isometric relaxation, stretching,
manual massage, tractions and mobilizations); patient
education in the back school principles. In patients of
the first group (gr 1) we added paravertebral infiltrations
(with corticosteroide, lidocaine and B vitamines). In the
next two groups a preformed physical modality was
included: lasertherapy (gr 2 - Laser) or deep oscillation
(DO - gr 3). Patients of the last two groups received
combined therapy (drugs plus physical analgesia): gr 4
– infiltrations and laser; gr 5– infiltrations +DO. Patients
were controlled before, during and at the end of the
rehabilitation course and one month after its end using
a battery of traditional and contemporaneous methods
for objectivization of the vertebral and radicular
syndromes (including visual analogue scale of pain,
vibroesthesiometry; thermosensibility; lassegue sign;
ICF assessment). Based on this detailed qualitative
and quantitative evaluation we proved the efficacy of
application of paravertebral infiltrations, laser therapy
and deep oscillation in the complex rehabilitation
algorithm of patients with back pain and lumbo-sacral
radiculopathy. Drug therapy is most effective during
the first days, physical analgesia begins slowly, but the
effect is most durable. We obtained better results in
groupswithcombined therapy (infiltrations andphysical
analgesia). We discuss some theories, concerning the
mechanisms of physical analgesia. Some aspects of
spinal biomechanics and kinesiology are mentioned.
The evidence proved the better efficacy of combined
analgesia in patients with low back pain and lumbo-
sacral radiculopathy.
Ivet B Koleva, Int J Anesth Pain Med 2019, Volume 5
DOI: 10.21767/2471-982X-C1-004