Therapy effects 12 years after a disc herniation operation

Low back pain is a common injury in the general adult population and is the most common cause for functional impairments. Lumbar discectomy is a frequently performed surgery in these patients. Short-term results revealed the functional benefit as well as pain reduction in these patients after receiving a post-operative physiotherapeutic treatment. However, no study so far evaluated long-term effects (>5 years) of post-operative comprehensive physiotherapy.

111 patients after an uncomplicated lumbar disc surgery participated in this study and were allocated to three groups. 74 patients received 20 sessions of physiotherapy over a period of 12 weeks. 22 patients received a 20 sessions “sham” neck massage of 30 minutes duration and 23 patients were asked to “wait and see” and received no treatment.

After 12 years lumbar back pain was reduced in all three groups. Especially patients who received a comprehensive physiotherapeutic treatment, as well as patients who received a sham treatment showed better outcomes. However, both groups failed to reach significant differences in comparison to the non-treatment group. 21% of patients who had received physiotherapy, 73% of those receiving sham treatment and 52% of those without any treatment reported on prevalent back and/ or leg pain. However, also these results did not reach the level of significance.

Overall this RCT showed that patients who received physiotherapy after disc surgery were more likely to recover to a good functional health state and indicated that patients who received physiotherapy have been able to maintain the beneficial effects. Although comprehensive physiotherapy may be superior to no intervention, it might not be superior to the sham group.

> From: Ebenbichler et al., Clin Rehabil 29 (2016) 548-560. All rights reserved to The Author(s). Click here for the Pubmed summary.