Results of complex treatment using manual therapy in patients with chronic vertebrogenic non-radicular lumbosciatica

Purpose: evaluation of the manual therapy effectiveness in the complex treatment of patients with chronic vertebrogenic non-radicular lumbosciatica.

Materials and methods. Clinical examination of 45 patients with chronic vertebrogenic non-radicular lumbosciatica included: visual inspection of the body; palpation; posture analysis; simple active movements and compound forms of motor patterns analysis; range of motion and segments/joints structure assessment, manual muscle testing; sensitivity and reflexes study; special neuro-orthopedic tests. The pain degree was evaluated according to a VAS and McGill questionnaire, disability assessment according to the Oswestry low back questionnaire, MRI of the lumbar spine was performed.

The results. Patients received complex treatment: manual therapy; muscle strengthening and stretching exercises; medicated lidocaine blockades in pain points; injections of chondroitin sulfate locally in the area of the affected segments, followed by a course of injections of glucosamine sulfate; electromyostimulation of the lumbar spine and buttock muscles; immobilization with a corset. The dynamics of the clinical examination results showed a statistically significant decrease in pain, improvement of the vertebral-motor segments and sacroiliac joints function, a decrease of regional muscle imbalances in antagonistic pairs, and an improvement patient’s vital functional activity.

Conclusions. The features of the revealed patient’s motor disorders allow us to justify effective complex treatment using manual therapy according to the existing pain syndrome, musculoskeletal system functional disorders with the elimination of regional muscle imbalances in antagonistic pairs and normalization of the functioning of the spine segments, sacroiliac joints movement.

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