1. Objective
To examine the effects of core muscle strengthening exercise on discogenic low back pain patients.
2. Subjects and Method
Total 270 patients suffered from low back pain only were enrolled retrospectively in the study. The low back pain patients received provocative manual discography for the diagnosis of discogenic low back pain(DLBP). Those patients of the positive provocative manual discography were selectively had intradiscal injection with mixture of steroid and local anesthetics medicine. The patients’ pain responses were checked in numeric rating scale(NRS) over time: baseline, 1 day, 1 month, 3 months, 6 months after the injection. One day after the intradiscal injection, the patients were categorized into 2 groups according to their pain response: >50% pain relief group(=positive response, PR); ≤50% pain relief group(=negative response, NR). The patients of the both groups were categorized into 2 subgroups depending on the core muscle strengthening exercise application more than 1 month: core muscle exercise subgroup(=PT subgroup); non-exercise subgroup(=NPT subgroup). The baseline and follow-up NRS of each group were compared. Intergroup differences in demographic and clinical data were assessed using Mann-Whitney test. ANOVA tests were performed to compare the NRS changes between each group. The “IBM SPSS Version 25.0” software package was used for the analysis.
3. Results
Overall, 131 DLBP patients were eligible for the 6-month follow-up period. Among those 131 DLBP patients, 75 patients reported reduced NRS more than 50% compared to the baseline NRS, which were allocated to PR group while the others were allocated to NR group. PR and NR groups were not significantly different in baseline characteristics according to Mann-Whitney analysis. Both PR and NR groups showed significant time-related NRS decrease. In NR group, the patients showed significant difference in the NRS at 6 months after the intradiscal injection between PT subgroup and NPT subgroup. This tendency of the NRS difference at 6 months after the intradiscal injection between PT and NPT subgroups were also proved in PR group.
4. Conclusion
The core muscle strengthening exercise could be applied to DLBP patients for supportive treatment especially for the patients whose analgesic intradiscal injections were not effective. The core muscle strengthening exercise can make difference on pain relief effect at 6 months after the intradiscal injection. Further studies for the relationship of DLBP pathophysiology and core muscle strengthening exercise are expected. |
