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A prospective study of mechanical physiotherapy for lumbar disk prolapse: five year follow-up and final report.

OBJECTIVES
To evaluate the long-term effect of a specific conservative treatment method for patients with lumbar disc prolapse.


BACKGROUND DATA
Low back pain and symptoms of disc herniation have a good prognosis. Yet the rates of disability and sick-leave because of recurrences are high and cost-intensive.


METHODS
Fifty consecutive patients with clinically and neuroradiologically confirmed lumbar disk prolapse, who responded to the first five daily physiotherapy sessions with pain centralization, were prospectively treated with mechanical physiotherapy with repeated end range spinal movements and leg movements. The results after one year of follow-up have been published previously (J Neurology 250 (2003), 746-749).


RESULTS
From the initial cohort of 50 patients, 5 patients were operated within one year after discharge and one patient died. One patient had surgery for disc prolapse 13 months after discharge. Three patients were lost for follow-up. None of the 40 remaining patients has had surgery until the last follow-up.


CONCLUSION
Pain centralization during the first 5 treatment sessions of mechanical physiotherapy is a useful diagnostic tool to predict a good longterm outcome. Mechanical physiotherapy with end range spinal movements and leg movements is an effective treatment strategy for many patients with lumbar disk disease.