Selective interventional therapy and exercise therapy for non-specific low back pain

Abstract

Introduction. Conservative treatment of non-specific low back pain (NSLBP) is not always effective. While the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants is currently a recognized criterion standard in the NSLBP treatment, the use of interventional therapy needs further clarification, and its use in combination with exercise therapy is not sufficiently covered. Aim. To evaluate the effectiveness of selective interventional therapy in combination with individual exercise therapy in patients with NSLBP. Materials and methods. A randomized controlled trial included 124 patients with NSLBP, aged 46.2±10.1 years, with a disease duration from 1 to 12 years. In the main group (n=102), selective interventional therapy with individual exercise therapy was used. The patients of the control group (n=22) were treated in accordance with the standard of medical care for NSLBP. The efficacy of treatment was evaluated using the developed quantitative assessment of biomechanical disorders of the spine. Results. The study showed that selective interventional therapy in combination with exercise therapy in patients with non-specific low back pain has an effect on various links in the pathogenesis of this disease. After the course of treatment, there was a significant decrease in biomechanical disorders (p<0.001), as well as in the intensity of pain according to VAS both after treatment and during catamnestic examination (p<0.001). Moreover, the highest rates were detected with discogenic pain syndrome, and the lowest rates - with spondyloarthrosis. Conclusion. Selective interventional therapy in combination with individual exercise therapy in patients with NSLBP contributes to the rapid recovery of biomechanical disorders in the spine and stable long-term remission.