Pain Management and Therapeutic Exercise of Lumbar Disc Herniations
Journal of the Korean Medical Association
E mail : M ost people will experience episodes are usually brief, resolve spontaneously, and recur infrequently. The successful management of persistent low back pain requires that treatment be directed to the pain producing structures in the human body. The spectrum of the treatment of low back pain ranges from very simple and straight foreword to very the complex and intricate. Treatments for lumbar disc herniations are conservative (75~90% of patients), invasive (5~10% of patients), and
... cal (5% of patients) treatments. Resolution of the first lumbar disc herniation takes place in approximately 75% of patient over a period of 3 months. With recurrent herniations, the chance of spontaneous relief of symptoms is reduced. In a very acute stage, the patient may require hospitalization to control the level of pain. Bed rest should be limited 2 days with the most comfortable position of the knee and the hip flexion about 80~90 degree. A few days of bed rest, adequate analgesics, and muscle relaxants to reduce muscle spasm usually are require. Physical therapeutic modality(included traction, heat, ultrasound, electrical stimulation), mobilization, manipulation, back school, spinal supports, therapeutic exercise and proper position should be used and educated. If the patient did not controled low back pain after above treatments, invasive treatments such as trigger point injection, facet or sacroiliac joint injection, epidural steroid injection, selective nerve root injection with high frequency heat therapy, or intradiscal injection may quickly alleviate symptoms. Every patient should attend a class in spine education as part of the overall treatment. Instruction is given in low back care, especially as related to the activities of daily living. Participants are taught correct posture, pelvic tilting, knee to chest exercise, and exercises to strengthen abdominal and paraspinal muscles. Individual instructions are given to each patient, explaining in more detail the nature of the patient's particular problem and how the individual can take control of the treatment.