Impact Of Multimodal Therapy Of Exercise, High Intensity Laser And Spinal Decompression In Low Back Pain With Lumbar Disc Herniation In Quito

IMPACT OF MULTIMODAL THERAPY OF EXERCISE, HIGH INTENSITY LASER AND SPINAL DECOMPRESSION IN LOW BACK PAIN WITH LUMBAR DISC HERNIATION IN QUITO David Cabrera, MD. Gabriel Benavides, MD, Christian Benavides, MD. Eliana Jimenez, PT. Anthony Pérez, PT. BACKGROUND: Low back pain is the most common cause of chronic pain in general adult population. The main cause of low back pain is mechanical etiology, and it is linked to behavioral changes and depression. Aims: To evaluate the use of a multimodal therapy in low back pain with lumbar disc herniation and the evolution of pain by relating it to scales such as PHQ9 (Patient Health Questionnaire 9), visual analogue scale (VAS) and ODI (Oswestry Disability Index) at the beginning and end of the protocol. METHODS: Retrospective cross-sectional study of adult patients treated at Clinica de Lesiones Deportivas in Quito from August 2022 to June 2023, with low back pain and lumbar disc herniation with concomitant depressive symptoms which received multimodal physical therapy. Patients were analyzed with special scales at the beginning and at the end of multimodal therapy during a 12-week follow-up period. RESULTS: Forty-eight patients were included (mean age: 41.46 years, SD: +/-14.553). Bivariate analysis, Pearson’s, and chi-squared variables were applied. The PHQ9 score decreased at the end of multimodal therapy in patients under 65 years old (p = 0.024), which indicates that young adult patients decreased symptoms related to depression. Younger patients had less pain at the end of multimodal therapy with the score on the ODI scale (p = 0.001). Patients with more weight, decreased their functional disability final ODI score (p = 0.03) and pain intensity at the end of treatment VAS (p = 0.008). CONCLUSIONS: The study demonstrates a decrease in low back pain and depressive behaviors with a 12-week follow-up protocol with multimodal physical therapy combined with exercise, high intensity laser and spinal decompression. Patients with higher body weight were more benefited than patients with lower body weight and young adult patients had better recovery rates and decreased pain compared to patients over 65 years.