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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.