Treatment of chronic low-back pain: a 1-year or greater follow-up

Musculoskeletal disorders are the most frequent cause of physical disability in developed countries. In particular, lower back pain is very common and represents a significant burden both in terms of patient suffering and costs. It is important to determine the most effective and efficient interventions in the treatment of this condition.

This article presents clinical outcomes in patients with chronic lower back pain involving ligamentous pathology treated by a physician who specializes in injection therapy for chronic musculoskeletal conditions and is able to tailor injection therapy specifically to each individual patient.

As a retrospective case series, patients from outpatient clinics in both rural and one urban centre were assessed, treated, and had 1 year or more follow-up.

Patients were referred by their family physician for assessment for chronic lower back pain refractory to conventional medical management.

Pain and quality of life (QoL) numeric (10 cm) analog scales (0 = no pain, 10 = the worst pain imaginable; 0 = best quality of life, 10 = worst quality of life) were administered pretreatment and 1 year or later after the last treatment.

One hundred and ninety (190) patients were treated during the study period, June 1999-May 2006. Patients whose follow-up was 1 year or greater from the last treatment were included, leaving 140 patients available for data analysis. Both pain and QoL scores were significantly improved at least 1 year after the last treatment. There were no differences in outcomes as a result of age, response to Xylocaine (lidocaine) injection, insurance coverage, smoking history, or gender.

This study suggests that prolotherapy using a variety of proliferants can be an effective treatment for low back pain from presumed ligamentous dysfunction for some patients when performed by a skilled practitioner.