Article

Therapeutic selective nerve root blocks (SNRBs) are a common
intervention for patients with sciatica. Patients often are referred to physical
therapy after SNRBs, although the effectiveness of this intervention sequence has
not been investigated. This study was a preliminary investigation of
the effectiveness of SNRBs, with or without subsequent physical therapy, in
people with low back pain and sciatica.
This investigation was a pilot
randomized controlled clinical trial. The settings were spine specialty
and physical therapy clinics. Forty-four participants (64% men;
mean age=38.5 years, SD=11.6 years) with low back pain, with clinical and imaging
findings consistent with lumbar disk herniation, and scheduled to receive SNRBs
participated in the study. They were randomly assigned to receive either 4 weeks
of physical therapy (SNRB+PT group) or no physical therapy (SNRB alone [SNRB
group]) after the injections. INTERVENTION: All participants received at least 1
SNRB; 28 participants (64%) received multiple injections. Participants in the
SNRB+PT group attended an average of 6.0 physical therapy sessions over an
average of 23.9 days. MEASUREMENTS: Outcomes were assessed at baseline, 8 weeks,
and 6 months with the Low Back Pain Disability Questionnaire, a numeric pain
rating scale, and the Global Rating of Change. RESULTS: Significant reductions in
pain and disability occurred over time in both groups, with no differences
between groups at either follow-up for any outcome. Nine participants (5 in the
SNRB group and 4 in the SNRB+PT group) underwent surgery during the follow-up
period. LIMITATIONS: The limitations of this study were a relatively short-term
follow-up period and a small sample size. CONCLUSIONS:
A physical therapy
intervention after SNRBs did not result in additional reductions in pain and
disability or perceived improvements in participants with low back pain and sciatica.

Langue : ANGLAIS