Therapy, Meds Best for Lumbar Low Back Pain

TUESDAY Feb. 3, 2009 -- A combination of physical therapy and anti-inflammatory drugs is the most effective treatment for low back pain caused by symptomatic lumbar degenerative disc disease, according to a review of published studies.

The review authors found that in 90 percent of people with low back pain, symptoms disappear on their own within three months and that most of those patients recover within six weeks.

Those findings indicate that, barring an emergency, initial treatment of all patients with low back pain should be noninvasive.

"Recently, disc replacement surgery has been proposed as a cure or treatment for symptomatic lumbar disc disease," review lead author Dr. Luke Madigan, an attending physician at Knoxville Orthopaedic Clinic in Tennessee, said in an American Academy of Orthopaedic Surgeons news release.

"But the FDA studies on lumbar disc replacement have only so far shown equivalence to fusion for discogenic disease," Madigan said. Long-term outcomes are still to be published and until then caution is advised, he said.

He also noted that the use of surgical fusion to treat symptomatic lumbar disc disease has a success rate of 50 percent to 60 percent.

Noninvasive treatments achieve greater success by helping patients strengthen the injured area and prevent further strain. These treatments include physical therapy, anti-inflammatory drugs, exercise, and patient education about body mechanics -- for example, lifting with the legs instead of the back.

The review was published in the February issue of the Journal of the American Academy of Orthopaedic Surgeons.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about low back pain.

Posted: February 2009


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