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Physiotherapy as an effective Treatment for lumbar Disc HerniationPhysiotherapy must be done for disc herniation patients before going 4 surgery even non of physician or surgeon has advised because physiotherapy is not a paramedical.It is an independent profession.If all the Neurosurgeons & orthopedic surgeons has advised surgery & forbaded 4 physiotherapy even then a patient should go 4 physiotherapy.A physiotherapist must also try 4 lumbar traction because it is an effective strategy.Allah has put shifa in it 4 these patients.thanks,Muhammad Rafiq Jami,Talha Physiotherapy Clinic,Ferozepur road,Lahore.00-92-322-4333045,00-92-42-35805870
Posted by: jami1995 Posts: 4 :: 11-11-2009 :: | Reply to this Message
Re: Physiotherapy as an effective Treatment for lumbar Disc Herniation
While i respect your opinion but i do think that there was no need of putting this particular post at three places
Secondly if there are red flag signs in a case of back pain ( progressive neurological deficit, severe pain not relived by medication and rest, saddle anesthesia and sphincter disturbance) then Lumbar traction ( and for that matter all conservative management ) are contraindicated and patient should seek urgent spinal surgeon / Neurosurgery review
Moreover this link will be helpful too
http://clinicalevidence.bmj.com/ceweb/conditions/msd/1118/1118_I15.jsp
Regards
Farooq
Posted by: drrathore Posts: 428 :: 11-11-2009 :: | Reply to this Message
Re: Re: Physiotherapy as an effective Treatment for lumbar Disc Herniation
and to quote an article which sums up the effect of lumbar traction in disc herniation very well
Man Ther. 2000 May;5(2):72-81.
Lumbar spine traction: evaluation of effects and recommended application for treatment.
Krause M, Refshauge KM, Dessen M, Boland R.
Despite the widespread use of traction, little is known of the mode of effect, and application remains largely anecdotal. The efficacy of traction is also unclear because of generally poor design of the clinical trials to date, and because subgroups of patients most likely to benefit have not been specifically studied. These observations prompted this review, the purposes of which are to evaluate the mechanisms by which traction may provide benefit and to provide rational guidelines for the clinical application of traction. Traction has been shown to separate the vertebrae and it appears that large forces are not required. Vertebral separation could provide relief from radicular symptoms by removing direct pressure or contact forces from sensitised neural tissue. Other mechanisms proposed to explain the effects of traction (e.g. reduction of disc protrusion or altered intradiscal pressure) have been shown not to occur. We conclude that traction is most likely to benefit patients with acute (less than 6 weeks' duration) radicular pain with concomitant neurological deficit. The apparent lack of a dose-response relationship suggests that low doses are probably sufficient to achieve benefit.
Posted by: drrathore Posts: 428 :: 11-11-2009 :: | Reply to this Message