Treatment modalities

  • Gunnar B. J. Andersson
  • Thomas W. McNeill


Treatment of low back pain and sciatica remains empirical. In this chapter different modalities will be reviewed and their values discussed. Specifics on when to use the treatment alternatives will be further discussed in the appropriate chapters.


Spinal Stenosis Epidural Morphine Anterior Fusion Facet Joint Injection Methyl Prednisolone Acetate 
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  1. Ahlgren SA, Hansen T (1978) The use of lumbosacral corsets prescribed for low back pain. Prosthet Orthot Int 2: 101–104PubMedCrossRefGoogle Scholar
  2. Andersson GBJ, Schultz A, Nachemson A (1983) Intervertebral disc pressures during traction. Scand J Rehabil Med 9: 88–91Google Scholar
  3. Buerger AA, Greenman PE (1985) Empirical approaches to the validation of spinal manipulation. Thomas, Springfield, OHGoogle Scholar
  4. Deyo RA (1983) Conservative therapy for low back pain. Distinguishing useful from useless therapy. JAMA 250: 1057–1062Google Scholar
  5. Deyo RA, Diehl AK, Rosenthal M (1986) How much bedrest for acute low back pain? N Engl J Med 315: 1064–1070PubMedCrossRefGoogle Scholar
  6. Dixon GW (1985) The current status of the scientific basis for manipulation. Curr Concepts Rehabil 2: 41— 43Google Scholar
  7. Ejeskär A, Nachemson A, Herberts P et al (1983) Surgery versus chemonucleolyis for herniated lumbar discs. Clin Orthop 174: 236–242PubMedGoogle Scholar
  8. Ghormley RK (1983) Low back pain with special reference to the articular facets with presentation of an operative procedure. JAMA Cl: 1773Google Scholar
  9. Gibson T, Harkness J, Blagrave P, Graham R, Woo P, Hills R (1985) Controlled comparison of short-wave diathermy treatment with osteopathic treatment in nonspecific low back pain. Lancet: 1258–1260Google Scholar
  10. Graham R (1980) Clinical trials in low back pain. Clin Rheum Dis 6: 143–157Google Scholar
  11. Hadler NM, Curtis P, Gillings DB, Stinnett S (1987) A benefit of spinal manipulation as adjunctive therapy for acute low back pain: a stratified controlled trial. Spine 12: 703 — 706Google Scholar
  12. Kane W (1977) Early detection of scoliosis. Orthopedic Digest 5: 13–17Google Scholar
  13. Kendall PH, Jenkins JM (1968) Exercises for backache: a double blind controlled trial. Physiotherapy 54: 154–157Google Scholar
  14. Kendall PH, Jenkins JM (1968) Lumbar isometric flexion exercises. Physiotherapy 54: 158–163Google Scholar
  15. Larsson U, Chöler U, Lidström A, Lind G, Nachemson A, Nilsson B, Roslund J (1980) Auto traction for treatment of lumbago-sciatica. A multicentre controlled investigation. Acta Orthop Scand 51: 791–798Google Scholar
  16. Ljunggren AE, Weber H, Larsen S (1984) Autotraction versus manual traction in patients with prolapsed lumbar intervertebral discs. Scan J Rehabil Med 16: 117–124Google Scholar
  17. McCulloch JA (1977) Chemonucleolysis. J Bone Joint Surg [Br] 59: 45–52Google Scholar
  18. McCulloch JA (1980) Chemonucleolysis. Experience with 2000 cases. Clin Orthop 146: 128–135PubMedGoogle Scholar
  19. McKenzie RA (1981) The lumbar spine: mechanical diagnosis and therapy. Waikanae, New ZealandGoogle Scholar
  20. Mayer T (1985) Using physical measurement to assess low back pain. J Musculoskeletal Med 6: 44–59Google Scholar
  21. Mooney V, Robertson J (1976) The facet syndrome. Clin Orthop 115: 149–156PubMedGoogle Scholar
  22. Nachemson AL, Elfstrom G (1970) Intravital dynamic pressure measurements in lumbar discs. Scad J Rehabil Med [Suppl] 1: 1–40Google Scholar
  23. Nachemson AL (1983) Work for all: for those with low back pain as well. Clin Orthop 179: 77–85PubMedGoogle Scholar
  24. Nachemson AL, Schultz AB, Andersson GBJ (1983) Mechanical effectiveness of lumbar spine orthoses. Scand J Rehabil Med 9: 139–149Google Scholar
  25. Nordby EJ (1983) Current concepts review. Chymopapain in intradiscal therapy. J Bone Joint Surg [Am] 65: 1350–1353Google Scholar
  26. Postacchini F, Lami R, Massobrio M (1987) Chemonucleolysis versus surgery in lumbar disc herniations. Spine 12: 87–96PubMedCrossRefGoogle Scholar
  27. Rees WS (1974) Multiple bilateral subcutaneous rhizolysis of segmental nerves in the treatment of intervertebral disc syndrome. Ann Gen Pract 26: 126Google Scholar
  28. Rothman RH, Simeon FA (1982) The spine. WB Saunders, PhiladelphiaGoogle Scholar
  29. Shealy CN (1976) Facet denervation in the management of back and sciatic pain. Clin Orthop 115: 157–164PubMedGoogle Scholar
  30. Spitzer WO et al (1987) Scientific approach to the assessment and management of activity related spinal disorders. Spine 12 [Suppl 1]: S1 —S 59Google Scholar
  31. Waddell G (1987) A new clinical model for the treatment of low back pain. Spine 12: 632–644PubMedCrossRefGoogle Scholar
  32. Ward NG (1986) Tricyclic antidepressants for chronic low back pain. Spine 11: 661–665PubMedCrossRefGoogle Scholar
  33. Watkins RG, Collis JS, Jr (1987) Lumbar discectomy and laminectomy. Principles and techniques in spinal surgery. Aspen, Frederick, MDGoogle Scholar
  34. Weber H, Burton K (1986) Rational treatment of low back trouble? Clin Biomech 1: 160–167CrossRefGoogle Scholar
  35. White AH, Rothman RH, Ray CD (1987) Lumbar spine surgery: techniques and complications. C V Mosby, St. Louis, MOGoogle Scholar
  36. Weinstein J, Spratt KF, Lehmann T, McNeill T, Hejna W (1986) Lumbar disc herniation. A comparison of the results of chemonucleolysis and open discectomy after 10 years. J Bone Joint Surg [Am] 68: 43–54Google Scholar
  37. Wiesel SW, Cuckler JM, DeLuca F et al (1980) Acute low back pain: an objective analysis of conservative therapy. Spine 5: 324–330PubMedCrossRefGoogle Scholar
  38. Williams CP (1965) The lumbosacral spine. McGraw Hill, New YorkGoogle Scholar

Copyright information

© Springer-Verlag/Wien 1989

Authors and Affiliations

  • Gunnar B. J. Andersson
    • 1
  • Thomas W. McNeill
    • 1
  1. 1.Department of Orthopedic SurgeryRush-Presbyterian-St. Luke’s Medical HospitalChicagoUSA

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