Nonmedical methods to relieve low back pain caused by lumbar disc herniation: a descriptive study in northeastern Turkey

A comparison between the low back pain scales for patients with lumbar disc herniation: validity, reliability, and responsiveness

Background

Although the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ), Numerical Pain Rating Scale (NPRS), Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire (RMDQ), and Short Form 36 Health Survey (SF-36) has shown a preferable psychometric properties in patients with low back pain (LBP), but no study has yet determined these in conservative treatment of patients with lumbar disc herniation (LDH). Thus the current study aimed to compare those scales in LDH patients receiving conservative treatment to select the better option to assess the severity of disease.

Methods

LDH patients were invited to complete the JOABPEQ, NPRS, ODI, RMDQ, and SF-36 twice. The internal consistency was evaluated by the Cronbach’s α. Test-retest reliability was tested by the intraclass correlation coefficient (ICC). The relationships of these scales were evaluated by the Pearson correlation coefficients (r). The responsiveness was operationalised using the receiver operating characteristic (ROC) curve, as well as the comparison of smallest detectable change (SDC), minimum important change (MIC).

Results

A total of 353 LDH patients were enrolled. Four subscales of the Chinese JOABPEQ were over 0.70, then the ICCs for the test-retest reliability were over 0.75. For functional status, remarked negative correlations could be seen between JOABPEQ Q2-Q4 and ODI, as well as RMDQ (r = − 0.634 to − 0.752). For general health status, remarkable positive correlations could also be seen between Q5 Mental health and SF-36 PCS (r = 0.724) as well as SF-36 MCS (r = 0.736). Besides, the area under of the curves (AUC) of the JOABPEQ ranged from 0.743 to 0.827, indicating acceptale responsiveness, as well as the NPRS, ODI, and RMDQ.

Conclusion

NPRS, and ODI or RMDQ is recommended in studies related to LDH patients, while if the quality of life also is needed to observe, the NPRS, and JOABPEQ would be more appropriate rather than SF-36.

The clinical factors associated with benefit finding of complementary medicine use in patients with back pain: A cross-sectional study with cluster analysis

BACKGROUND

Complementary and alternative medicine (CAM) use has been increasing.

OBJECTIVE

To identify the factors associated with perceived benefit from CAM methods in back problems.

METHODS

The study was conducted on patients who practiced any CAM methods due to complaints of back pain. Social-demographic properties, details of CAM methods employed were questioned. Severity of pain was measured by visual analog scale (VAS); benefits were evaluated by the Likert scale. Hierarchical cluster analysis was used to discover relationships among variables.

RESULTS

In total, 500 patients (265 female, 235 male) were included in the study. Mostly used methods were herbal therapy (32%), balneotherapy (31%), cupping (19.4%) and massage-manipulation (19.2%). Of patients, 355 (71%) were satisfied. The variables associated with benefit finding were female gender, age, chronicity and severity of pain, high educational level, upper middle income status, use as a result of recommendation, dissatisfaction with conventional methods, residence in an urban area, non-herbal method use, being married, and social insurance (p < 0.005).

CONCLUSION

The majority of patients using CAM perceived benefits; in particular, women living in urban areas, highly educated, aged more than 40, who suffer from severe chronic back pain, may be more inclined to go to CAM therapists.

Irregular Alteration of Facet Orientation in Lumbar Segments: Possible Role in Pathology of Lumbar Disc Herniation in Adolescents

BACKGROUND

The role of the overall structural feature of facet joint in the development of lumbar disc herniation (LDH) is unclear. The present study aimed to investigate the role of irregular alteration of facet orientation (IAFO) in low lumbar segments in the pathology of LDH in adolescents.

METHODS

Sixty-five adolescents with LDH were included in the study. Facet angles were measured in magnetic resonance imaging. The IAFO was defined as the irregular orientation of the included facet joints angle, which was regularly increased from L3 to S1 in the normal group, including small-large-small (SLS) type, large-small-large (LSL) type, and large-small-smaller (LSS) type. Thirty normal adolescents without lumbar lesions were selected into the control group. Statistical analysis was performed using χ(2) test.

RESULTS

IAFO was observed in 20 of 65 subjects in LDH group compared with 3 of 30 in the control group [P = 0.038; OR=4 (1.086, 14.735)]. The SLS type was observed in 14 patients, and the LSL type was found in 6 patients, compared with 2 and 1, respectively, in the control group, no LSS type was found in the two groups. There were 8 subjects with IAFO of SLS style herniated in L5/S1 level compared with 6 subjects in L4/5. There was 1subject with IAFO of LSL style herniated in L5/S1 level compared with 5 subjects in L4/5.

CONCLUSIONS

The findings of this study suggest that the IAFO in the lumbar spine was associated with lumbar disc herniation in adolescents.