Rp. Difabio et al., PHYSICAL THERAPY OUTCOMES FOR PATIENTS RECEIVING WORKERS COMPENSATIONFOLLOWING TREATMENT FOR HERNIATED LUMBAR DISC AND MECHANICAL LOW-BACK-PAIN SYNDROME, The Journal of orthopaedic and sports physical therapy, 23(3), 1996, pp. 180-187
Outcome of physical therapy for patients receiving workers' compensati
on may be related to a variety of factors, including the presence or a
bsence of herniated lumbar intervertebral disc. The purpose of this st
udy was to determine the level of disability, physical impairment, and
rate of return-to-work for patients with disc disease and for those w
ith mechanical low back pain syndrome without evidence of disc lesion.
Twenty patients with disc disease and 22 patients with mechanical low
back pain syndrome participated in this study. Physical therapy consi
sted of multiple interventions, including manual therapy based on the
pattern of motion-provoked symptoms. The Oswestry disability questionn
aire, fingertip-to-floor distance, and maximum pain-free isometric sta
tic lift were measured at the initial evaluation, I month following th
e initial assessment, and at discharge from the clinic. Patients with
disc disease did not show significant improvement in the mean Oswestry
score or in forward bending, but did show increased static lift capac
ity. In contrast, patients with mechanical low back pain syndrome had
a significant reduction in disability and significant improvements in
fingertip-to-floor distance and maximum pain-free isometric static lif
t At the time of discharge, 90% of the patients followed with mechanic
al low back pain syndrome returned to work in some capacity compared w
ith 45% of the patients followed with disc disease. A physical therapy
program with multiple interventions that includes treatment based on
the pattern of motion-provoked symptoms appears to have the greatest b
enefit for patients with mechanical low back pain syndrome.