Physiotherapy may empower disc herniation patients

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A study presented at the annual meeting of International Society for the Study for the Lumbar Spine (13–17 May, Scottsdale, USA) indicates that patients with lumbar disc herniation who undergo a structured course of physiotherapy often express feelings of well-being three years after treatment whereas patients who undergo surgery often express feelings of ill feeling after three years—suggesting that structured physiotherapy may empower patients.

The study has also been published in the Journal of Rehabilitation Medicine. Writing in the journal, Gunilla Limbäck Svensson (Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden) and others stated that qualitative interview studies, using open-ended questions, gave “patients the opportunity to describe their experiences without being guided by standardised questionnaires.” The authors added that such studies may be of benefit in patients after receiving treatment for disc herniation as they could provide a “better understanding of health than questionnaires”. Limbäck Svensson et al commented that there were no long-term qualitative studies of patients who had received treatment for disc herniation, reporting: “The aim of this study was therefore to describe the experience of health among patients three years after treatment with a structured physiotherapy model or surgery due to lumbar disc herniation.”


In the study, the authors assessed 20 patients (all of whom were eligible for surgery) three years after they had received treatment for sciatica due to lumbar disc herniation—10 of whom had received surgery and 10 of whom had undergone a course of physiotherapy. In each group, five patients had chosen their mode of treatment and five had been randomised to receive that treatment. Patients were interviewed with open-ended questions, such as “Please, describe how you are feeling”.  


Limbäck Svensson et al found that patients who had undergone a course of physiotherapy often expressed a feeling of well-being, commenting that they felt fine, had no symptoms, or were active despite having symptoms. However, patients who underwent surgery often expressed a feeling of ill-being, stating that they had psychological symptoms, physical symptoms, or avoided physical activity. At the ISSLS meeting, Limbäck Svensson concluded: “The variation between the two groups may be explained by the ability of the structured physiotherapy model to empower the patients. Patients who undergo surgery may benefit from treatment that increases their empowerment to improve feelings of well-being.”

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