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J Korean Med Assoc > Volume 47(9); 2004 > Article
Cho: Physical Therapy and Pharmacological Treatment of Lumbar Disc Herniations

Abstract

In the industrialized world, low back pain is second only to headache as a cause of pain. It is the leading cause of expenditure for Workers' Compensation. Some 50~80% of adults will have low back pain at some time in their lives. Risk factors that influence the incidence or prevalence of low back pain are hard labor and heavy exertions, age, gender, anthropometric factors, postural factors, spine mobility, muscle strength, physical fitness, smoking, and psychosocial factors. Lumbar disk syndrome is a common cause of acute, chronic, or recurrent low back pain, particularly in young to middle-aged men. Most patients with discogenic low back pain respond well to conservative managements. Conservative treatments of back pain traditionally have included rest, avoidance of stressful activities, use of back supports, exercise, physical therapy, medication, traction, and nerve block. As in any acute injury, cold packs decrease edema for initial 48 hours, and then hot pack or radiant ramp for 20~35 min is used for control of acute back pain. Electrotherapy and deep heat can also be used. For acute discogenic disorders, the use of simple analgesics every 4 to 6 hours is also helpful. Adequate analgesia with acetaminophen, NSAIDs, or a short course of sedative muscle relaxants or even synthetic opiates may be recommended. Spinal orthosis is helpful to prevent a severe painful spasm of paraspinal muscles and to maintain a proper posture of the spinal column.

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Table 1
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BM : bone marrow, CNS : central nervous system, COX : cyclooxygenase, G : gastrointestinal, R : renal

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Table 7
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