Conservative treatment of low back conditions.
Occupational safety and health symposia 1977. Cincinnati, OH: U.S. Department of Health, Education, and Welfare, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health, DHEW (NIOSH) Publication No. 78-169, 1978 Jun; :34-36
Conservative treatment of low back conditions was discussed. Most persisting low back pain with or without sciatica is regarded as being due to a lumbar disc lesion. It was suggested that except in rare cases, even patients with disabling symptoms from lumbar disc lesions should be given at least 3 to 6 weeks of conservative treatment before making a decision about surgery. The usual muscular spasm or wrenching injury of the low back causes symptoms that should resolve after several weeks of conservative treatment. Conservative treatment practices were described. Conservative treatment usually begins with rest and splinting the back with a lumbosacral support, heating with warm soaks or showers, resting in contour chair positions, and using symptomatic medications. Physical therapy modalities of local heat, massage, diathermy, ultrasound, or whirlpool baths were regarded as being potentially helpful. Hospital management (bed rest with back and knee support and leg or pelvic traction) should be considered for patients with more severe disabling symptoms. The medicolegal aspects of low back pain with or without functional overlay were discussed. It was noted that in medicolegal cases, the greater the amount of potential financial gain, the greater was the percentage of functional or psychogenic overlay. The author concludes that surgery may be necessary for severely disabled patients who do not respond to conservative treatment.
NIOSH-Contract; Contract-210-77-0088; Back-injuries; Musculoskeletal-system; Medical-treatment; Occupational-health; Psychological-factors; Spinal-cord; Musculoskeletal-system-disorders
Occupational safety and health symposia 1977