Treatment of Sciatica and Lumbar Radiculopathy with an Intervertebral Foramen Opening Protocol: Pilot Study in a Hospital Emergency and In-patient Setting

Michael Shacklock, Marinko Rade, Siniša Poznic, Anita Marčinko, Michael Fredericson, Heikki Kröger, Markku Kankaanpää, Olavi Airaksinen

    Research output: Contribution to journalArticleScientificpeer-review

    Abstract

    Aims: Perform a pilot study of a static nerve root foramen opening protocol for lumbar radiculopathy from disc hernia in an emergency hospital setting to establish if patients could execute the protocol, consistency would occur across outcomes, superior outcomes would occur in the experimental group, and if the protocol would be safe. Methods: Patients with sciatica arrived of their own volition at the local emergency hospital department, were admitted for care and were randomized into two groups: 1) control (n = 10): forward bending, walking, and medication; and 2) experimental (n = 10) as control subjects, plus a static lumbar foramen opening protocol using flexion and contralateral lateral flexion (side-lying). Outcomes were back and leg pain (i.e. visual analog scale), disability (i.e. EuroQol5D5L and Oswestry) and straight leg raise. Results: At admission, the baseline outcome variables between groups were not significantly different. All patients had moderate or large disc hernias on MRI and 75% had neurological deficits in electrophysiology. At discharge, patients in the experimental group were significantly better (p ≤ .05) than controls in all outcomes. Statistical analysis of the outcomes produced greater significance, effect sizes and minimal clinically important differences in the experimental group. Patients in the experimental group consumed less medication than control patients (21% versus 79%), including less than half the opioids (tramadol). No adverse responses occurred. Conclusions: Patients could perform the protocol and superior outcomes occurred, with no adverse effects. The data support more detailed study of therapeutic efficacy, days in hospital, costs, conversion to surgery, and medication consumption, including opioids.

    Original languageEnglish
    Pages (from-to)1178-1188
    JournalPHYSIOTHERAPY THEORY AND PRACTICE
    Volume39
    Issue number6
    Early online dateMar 2022
    DOIs
    Publication statusPublished - 2023
    Publication typeA1 Journal article-refereed

    Keywords

    • Lumbar radiculopathy
    • physiotherapy
    • sciatica

    Publication forum classification

    • Publication forum level 1

    ASJC Scopus subject areas

    • Physical Therapy, Sports Therapy and Rehabilitation

    Fingerprint

    Dive into the research topics of 'Treatment of Sciatica and Lumbar Radiculopathy with an Intervertebral Foramen Opening Protocol: Pilot Study in a Hospital Emergency and In-patient Setting'. Together they form a unique fingerprint.

    Cite this