Effectiveness of Physical Therapy Management for Patients with Lumbar Spine Disc Herniation: A Literature Review
Jennifer Duffie, SPT; Bradley Ponder, SPT; Sarah Berry, SPT; Andrew Bick, SPT
Faculty Mentor: Mohamed Kohia, PT, Ph.D., MS
Jennifer Duffie, SPT; Bradley Ponder, SPT; Sarah Berry, SPT; Andrew Bick, SPT
Faculty Mentor: Mohamed Kohia, PT, Ph.D., MS
Institution(s): Rockhurst University Department of Physical Therapy, Kansas City, MO
Purpose/Hypothesis: The purpose of this review is to explore various physical therapy management techniques for individuals with lumbar spine disc herniation to determine the most effective treatment method.
Subjects: Peer-reviewed studies were analyzed that included patients who had low back pain due to a lumbar herniated disc.
Methods/ Materials: Databases search included CINAHL, PubMed, MEDLINE, Google Scholar, Cochrane Library, and Academic Search Complete. All articles were investigating conservative interventions within the physical therapy scope of practice for lumbar disc herniation; written in English, peer-reviewed, and had a 2008 to present date restriction. Key phrases like, “physical therapy AND herniated discs AND treatment,” “lumbar disc herniation AND exercise NOT surgery,” and “physical therapy management AND herniated disc” were used to search for the articles. All studies found were evaluated using Sacket’s Levels of Evidence, grades of recommendation, and the Megan and Harris Criteria for Scientific Rigor.
Results: Twenty-seven studies were critically evaluated and classified according to Sackett’s Levels of Evidence and Megan and Harris Criteria for Scientific Rigor. Fourteen studies were categorized as level I, five studies as level II, three studies as level III, two studies as level IV, and three studies as level V. One study met all criteria for scientific rigor and four articles missed one or two of the criteria. A total of fourteen articles produced grade A, four articles produced grade B, and nine articles produces grade C recommendations. Grade A recommendations are supported by level I studies that met most criteria of the scientific rigor, and consequently provide the highest evidence.
Conclusions: The research supports physical therapy intervention to decrease pain and improve function in individuals with lumbar disc herniation. No single intervention was proven to be superior to other interventions, however the use of lumbar stabilization training, dry needling, and traction is very effective for treatment and management of a lumbar disc herniation.
Funding Source: No additional sources of funding
Purpose/Hypothesis: The purpose of this review is to explore various physical therapy management techniques for individuals with lumbar spine disc herniation to determine the most effective treatment method.
Subjects: Peer-reviewed studies were analyzed that included patients who had low back pain due to a lumbar herniated disc.
Methods/ Materials: Databases search included CINAHL, PubMed, MEDLINE, Google Scholar, Cochrane Library, and Academic Search Complete. All articles were investigating conservative interventions within the physical therapy scope of practice for lumbar disc herniation; written in English, peer-reviewed, and had a 2008 to present date restriction. Key phrases like, “physical therapy AND herniated discs AND treatment,” “lumbar disc herniation AND exercise NOT surgery,” and “physical therapy management AND herniated disc” were used to search for the articles. All studies found were evaluated using Sacket’s Levels of Evidence, grades of recommendation, and the Megan and Harris Criteria for Scientific Rigor.
Results: Twenty-seven studies were critically evaluated and classified according to Sackett’s Levels of Evidence and Megan and Harris Criteria for Scientific Rigor. Fourteen studies were categorized as level I, five studies as level II, three studies as level III, two studies as level IV, and three studies as level V. One study met all criteria for scientific rigor and four articles missed one or two of the criteria. A total of fourteen articles produced grade A, four articles produced grade B, and nine articles produces grade C recommendations. Grade A recommendations are supported by level I studies that met most criteria of the scientific rigor, and consequently provide the highest evidence.
Conclusions: The research supports physical therapy intervention to decrease pain and improve function in individuals with lumbar disc herniation. No single intervention was proven to be superior to other interventions, however the use of lumbar stabilization training, dry needling, and traction is very effective for treatment and management of a lumbar disc herniation.
Funding Source: No additional sources of funding