Improvement during the follow-up period was found in both the methylprednisolone and saline groups. The combination of methylprednisolone and bupivacaine seems to have a short-term effect, but at 3 and 6 months, the steroid group seems to experience a "rebound" phenomenon.
In addition to short-term effectiveness for contained herniations and lesions at L3-L4-L5, steroid treatment also prevented surgery for contained herniations. However, steroid was countereffective for extrusions. The results of the subgroup analyses call for a verification study.
The aim of this study was to investigate how cold exposure may be associated with musculoskeletal problems either on symptomatic or disease level based on available relevant scientific literature. The data collection resulted in ten scientific articles, from which nine were epidemiological and one a case report consisting of three cases. The results indicated that musculoskeletal symptoms are more frequent in cold store work and in related conditions than in normal temperature work and symptoms seems to be increased when the working time in cold environment increases. In cold store work low back pain and knee pain are more frequent problems than in normal temperature working environment. The association between cold exposure and shoulder pain is still unclear and has been poorly studied. Meteorological conditions, principally low ambient temperature may have an effect of reported low back pain in a remarkable part of population. In the etiology of tenosynovitis cold exposure has a specific role either as a causative or a contributing factor. The risk for carpal tunnel disease is 2.2-fold in repetitive wrist movements compared with no repetition and 9.4-fold when cold exposure added. Cold exposure in work seems to be is associated with a little increased risk (Odds ratio 2.2) for degenerative discopathies of lower back in men. However, this risk is small and seems to be associated with other physical factors in the background. In conclusion, the associations between cold exposure and musculoskeletal complaints or diseases are shown in some studies and the need of further research is apparent.
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