SJUKGYMNASTIK SOM BEHANDLING VID LÄNDRYGGSDISKBRÅCK

Sammanfattning: ABSTRACT Background: Most cases of lumbar disc herniation are asymptomatic. When symptomatic, LDH may cause a significant physical and mental distress. Initially, most patients are treated conservative but sometimes operations may be required. Aim: The aim of this study was to provide a review of the scientific basis of physiotherapy, including behavioural therapy, as a treatment to lumbar disc herniation regarding pain, function and the size of disc herniation in people suffering from lumbar disc herniation. Method: Four databases were used in the searches of literature. Assessment of the validity of the studies was done with the PEDro-scale and valuation of evidence rate was made according to guidelines made by the Swedish Council on Health Technology Assessment (SBU). Result: Nine RCT-studies were included with a total of 713 participants. The scientific basis is moderate to support a pain reduction and limited regarding improvement of physical function when it comes to physical exercises, including MDT. There is also a limited scientific basis supporting a reduction of pain from manipulation. Laser, on the other hand, showed a limited scientific basis to have no effect on pain. Traction and acupuncture had an insufficient scientific basis. Overall there were an insufficient scientific basis on the size of disc herniation.There was no study found examining the efficacy on behavioural therapy. Conclusion: The scientific basis is moderate to support a pain reduction when it comes to physical exercises, including MDT. There were few studies of high evidential rate and the scientific basis is difficult to determine due to heterogeneous studies. Additional science is required to determine which physiotherapy methods are the most effective for patients with lumbar disc herniation.