Non-Surgical Management of Disc-Related Low Back Pain: An Algorithmic Approach and Practical Guideline

Pardis Noormohammadpour; Mohammad Hossein  Pourgharib Shahi; Shima Ghannadi; Mahshid Nazarieh; Faezeh Maleklou; Fatemeh Ejtehadi; Babak Mirzashahi

doi:10.18502/jmr.v18i2.15969

Pardis Noormohammadpour Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Hossein Pourgharib Shahi Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Shima Ghannadi Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Mahshid Nazarieh Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Faezeh Maleklou Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Fatemeh Ejtehadi Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Babak Mirzashahi Department of Orthopedic Surgery, Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/jmr.v18i2.15969

Keywords: Radiculopathy; Low back pain; Pain management

Abstract

Introduction: Low back pain (LBP) is a common health problem worldwide and the primary cause of years lived with disability. Studies on the non-surgical management approaches for disc-related LBP are sparse and scarce, so a clear and structured guideline in this area would be useful. This study summarizes the non-surgical management approaches for disc-related LBP in a review.

Materials and Methods: Intervention studies and review articles relating to the non-surgical approaches for disc-related LBP treatment were curated from PubMed, EMBASE, Cochrane, and Google Scholar databases before July 1, 2022.

Results: Several management approaches are suggested in the studies for disc-related LBP, including medications, acupuncture, lumbar orthoses, exercise therapy, manual therapy, physical therapy modalities, and spinal injections. Some of these options have been studied more, like exercise therapy and injections, and there are more favorable reports for them. Some others have been less studied and need to be investigated in future studies, like different physical therapy modalities.

Conclusion: Recommendations are based on low- to moderate-quality evidence or consensus in the management approach studies for disc-related LBP. Therefore, the authors recommend intensifying research efforts concerning all aspects of the non-surgical management of LBP.