The Role of the Back Rx Exercise Program in Diskogenic Low Back Pain: A Prospective Randomized Trial

Abstract 

Vad VB, Bhat AL, Tarabichi Y. The role of the Back Rx exercise program in diskogenic low back pain: a prospective randomized trial.

Objective

To determine the efficacy of the Back Rx program in patients with diskogenic low back pain (LBP).

Design

Prospective, randomized study.

Setting

Outpatient setting of a major university teaching hospital.

Participants

Subjects with LBP greater than leg pain for at least 3 months duration and magnetic resonance imaging evidence of disk pathology. Fifty of 87 eligible patients consented and were randomized into age- and sex-matched groups.

Interventions

Group I participated in the Back Rx program for 15 minutes a day, 3 times a week. All patients, from both groups, received celecoxib (200mg) and hydrocodone (5mg) with acetaminophen (500mg) as needed, and wore a lumbar cryobrace for 15 minutes before bedtime.

Main Outcome Measures

Roland-Morris Disability Questionnaire score, numeric pain rating score, patient satisfaction score, measured forward flexion, use of celecoxib, hydrocodone, and acetaminophen, time off work, and rate of symptom recurrence.

Results

At minimal 12-month follow-up, 70% of group I reported over 50% pain reduction with good or better patient satisfaction, compared with 33% in group II (P=.001). Average daily hydrocodone and acetaminophen use and time off work were less for group I (all, P<.05). Recurrence of symptoms at the end of the year was less for group I (P=.001).

Conclusions

Back Rx exercises, combined with use of a lumbar cryobrace and oral medications, yielded superior therapeutic results than with use of medications and cryobrace alone. Also significant was the reduced rate of recurrence in these patients.

Key Words: Exercise, Intervertebral disk, Low back pain, Rehabilitation