Treatment of Chronic Low-Back Pain: A 1-Year or Greater Follow-Up

Abstract

Background:

Musculoskeletal disorders are the most frequent cause of physical disability in developed countries. In particular, lower back pain is very common and represents a significant burden both in terms of patient suffering and costs. It is important to determine the most effective and efficient interventions in the treatment of this condition.

Purpose:

This article presents clinical outcomes in patients with chronic lower back pain involving ligamentous pathology treated by a physician who specializes in injection therapy for chronic musculoskeletal conditions and is able to tailor injection therapy specifically to each individual patient.

Design:

As a retrospective case series, patients from outpatient clinics in both rural and one urban centre were assessed, treated, and had 1 year or more follow-up.

Methods:

Patients were referred by their family physician for assessment for chronic lower back pain refractory to conventional medical management.

Outcome measures:

Pain and quality of life (QoL) numeric (10 cm) analog scales (0 = no pain, 10 = the worst pain imaginable; 0 = best quality of life, 10 = worst quality of life) were administered pretreatment and 1 year or later after the last treatment.

Results:

One hundred and ninety (190) patients were treated during the study period, June 1999–May 2006. Patients whose follow-up was 1 year or greater from the last treatment were included, leaving 140 patients available for data analysis. Both pain and QoL scores were significantly improved at least 1 year after the last treatment. There were no differences in outcomes as a result of age, response to Xylocaine (lidocaine) injection, insurance coverage, smoking history, or gender.

Conclusions:

This study suggests that prolotherapy using a variety of proliferants can be an effective treatment for low back pain from presumed ligamentous dysfunction for some patients when performed by a skilled practitioner.