title: Evaluation of perifacet injections and paraspinal muscle rehabilitation in treatment of low back pain. A randomised controlled trial.
abstract: BACKGROUND
  Lumbar paraspinal muscle dysfunction and Low Back Pain are strongly correlated. The best treatment for non-specific Low Back Pain is still controversial.
  
  
  OBJECTIVE
  To evaluate the efficacy of lumbar multifidus muscle retraining exercises and perifacet multifidus injections in the treatment of Low Back Pain.
  
  
  METHODS
  63 patients with non-specific LBP, with or without leg pain, and magnetic resonance images of paraspinal muscle degeneration only, were randomised to one of three treatment groups: A- Back education and standard physiotherapy for 10 weeks, B- Back education and gym ball exercise for 10 weeks or C- Perifacet injection into the lumbar multifidus muscle with methylprednisolone. The Oswestry Disability Index was used as the primary outcome measure and the SF-36, modified Zung depression index, modified somatic perception and McGill pain questionnaires were used as secondary outcome measures.
  
  
  RESULTS
  56 patients completed the trial. The Oswestry Disability Index improved in general from a mean of 29.9 to 25.9, but there were no statistically significant differences between the groups. Low back pain improved most in group C (P<0.02), while physical activities and social functioning were improved the most in group B (P<0.03).
  
  
  CONCLUSIONS
  Perifacet injection and back education including a gym ball exercise program may be more effective than back education alone in relieving pain and improving physical capacity respectively. Back education including gym ball exercise could be used for non-specific Low Back Pain, as the ultimate goal should be to restore function.
authors: Queen Elizabeth Hospital, Sheriff Hill, Gateshead, Tyne and Wear, UK.
authors: Deiary
authors: D
authors: Kader
authors: Sarkhell
authors: S
authors: Radha
authors: Francis
authors: F
authors: Smith
authors: Douglas
authors: D
authors: Wardlaw
authors: Neil
authors: N
authors: Scott
authors: Amol
authors: A
authors: Rege
authors: M
authors: M
authors: Pope
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007268:Injections, Epidural; D007278:Injections, Spinal; D017116:Low Back Pain / Q000188:drug therapy* / Q000534:rehabilitation* / Q000628:therapy; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D052580:Muscle Stretching Exercises / Q000379:methods*; D010147:Pain Measurement; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone