Evaluation outcome of the regional approach of physiotherapy, conventional approach of physiotherapy and non-steroidal anti-inflammatory drugs (NSAID) on anxiety for chronic mechanical spinal pain disorder

Abstract

Introduction: Chronic pain and psychiatric disorders frequently co-occur. Anxiety followed by chronic spinal pain is not properly addressed. The purpose of the study is to compare effectiveness of the regional approach (new approach) of physiotherapy treatment, NSAID and conventional physiotherapy approach on pain and disability status for chronic mechanical spinal pain disorder. Materials and Method: A repeated measurement ANOVA clinical trial design was carried out to test the hypothesis. 104 patients between 20-65 years old with chronic mechanical spinal pain were randomly assigned into 3 different groups. Measurements were taken before starting of intervention, middle of the intervention and at the end of the intervention. The regional group (30 patients) received 8 sessions of regional approach of Physiotherapy, conventional group (35 patients) received 8 sessions of conventional approach of physiotherapy treatment and drug group (39 patients) received 21 to 30 days NSAID as per prescription of an orthopedic Professor. To eliminate bias, clinical physiotherapists were also randomly allocated into either for regional approach physiotherapy group or as usual physiotherapy group. A treatment protocol of regional approach was developed and handed over to clinical physiotherapists for regional approach group to deliver treatment. Outcome was monitored by Hamilton Anxiety rating scale. Results: The results of the study show that the regional approach of physiotherapy treatment, NSAID and conventional physiotherapy approach are differentially effective on anxiety status (P<0.05). The outcome of anxiety was differently effective over different occasions of treatment (pretest, mid-test and posttest) for chronic mechanical spinal pain (P<0.05). Alongside the effect of time and treatment interaction of anxiety was also found to be statistically significant (P<0.05). Greater improvement of anxiety has been shown in regional group in comparison to conventional and NSAID group. Conclusion: Regional approach of treatment has been found to be a new evidence of treatment for chronic mechanical spinal pain in reduction of anxiety level. The study demonstrates short term outcome of the treatment methods. However, a further study is required to see the long term effect of those treatments.

"Outcome evaluation of physiotherapy & drug management for chronic cervical radiculopathy"

“…27 Regional approach (RA) is an open-ended theoretical basis of assessment and figuring out what chain mechanism is impaired and treating a region or multiple joints/structures. 13 Structural diagnosis and management (SDM) is a structured process that can detect the specific structure(s) involved in the impairment and measure the extent of involvement. The management approach of the regional approach can be implemented by active means such as selftreatment or passive means when the therapist releases or stretches.…”

“…The treatment components are basic manual therapy approaches categorized by correction of asymmetry of alignment, treatment of soft tissues, and restoration of mobility. The RA treatment team consists of 5 physiotherapists working in a musculoskeletal physiotherapy set-up supervised by another physiotherapist with a doctoral degree in evaluating RA concepts 13 on spinal mechanical problems.…”

“…The study suggests RA is superior to McKenzie MDT and medication alone to reduce pain, improve cervical mobility, improve cervical muscle strength, reduce disability, and improve quality of life in Chronic spinal mechanical pain patients. 13 Structural diagnosis and management (SDM) is a newly developed approach for mechanical disorders of the spine causing neuromuscular impairments 14 that involves a comprehensive assessment of the mechanical problems of a spinal segment focusing not only the affected segment but also the complete spinal and peripheral biomechanics. There are similarities between RA and SDM, but despite seeking the source of musculoskeletal problems in a scattered way, the SDM concept categorizes the problems as muscular dysfunction, myoneural dysfunction, and complete mechanical dysfunction based on the pattern and nature of neuromuscular structures involved.…”

Physiotherapy versus pain medication for managing chronic cervical radiculopathy: protocol for a multi-arm parallel-group randomized clinical trial

“…The study suggests RA is superior to McKenzie MDT and medication alone to reduce pain, improve cervical mobility, improve cervical muscle strength, reduce disability, and improve quality of life in chronic spinal mechanical pain patients. 13 Structural diagnosis and management (SDM) is a newly developed approach for mechanical disorders of the spine causing neuromuscular impairments 14 that involves a comprehensive assessment of the mechanical problems of a spinal segment focusing not only the affected segment but also the complete spinal and peripheral biomechanics. There are similarities between RA and SDM, but despite seeking the source of musculoskeletal problems in a scattered way, the SDM concept categorizes the problems as muscular dysfunction, myoneural dysfunction, and complete mechanical dysfunction based on the pattern and nature of neuromuscular structures involved.…”

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“…Neck pain (NP) and low back pain (LBP) are seemed to be massive public health problems because of multiple aspects including their high incidence, long duration, and social and economic impact. 1 According to a global review, the one-year prevalence of neck pain ranges between 16.7% and 75.1% (mean 37.2%). 2 Another study shows that the overall occurrence of neck pain in the general population is estimated between 0.4 % and 86.8% and one-year prevalence ranges from 4.8% to 79.5%.…”