Archives of Physical Medicine and Rehabilitation
Volume 77, Issue 11 , Pages 1189-1197, November 1996

Randomized controlled trials in industrial low back pain relating to return to work. Part 2. Discogenic low back pain☆

  • Steven J. Scheer, MD

      Affiliations

    • Corresponding Author InformationReprint requests to Steven J. Scheer, MD, Department of Physical Medicine and Rehabilitation, University of Cincinnati Medical Center, PO Box 670530, Cincinnati, OH 45267-0530.
    • Department of Physical Medicine and Rehabilitation, University of Cincinnati Medical Center, Cincinnati, OH USA
    • ,
  • Kenneth L. Radack, MD

      Affiliations

    • Department of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, OH USA
    • ,
  • David R. O'Brien Jr., MD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, University of Cincinnati Medical Center, Cincinnati, OH USA

Received 6 December 1994; accepted 27 September 1995.

Article Outline

Abstract 

The purpose of this review was to determine the efficacy of treatments for discogenic low back pain (LBP) by examining all randomized controlled trials (RCTs) of discogenic LBP published in the English language literature between 1975 and 1993 with “return to work” (RTW) as the end point. From more than 4,000 LBP citations, nearly 600 articles were initially reviewed; 35 studies met our selection criteria. Twenty-two studies were discussed in Part 1 (Acute Interventions) or will be discussed in Part 3 (Chronic Interventions). In this review, of 13 RCTs assessing interventions for LBP with sciatica, 9 were appropriate for their focus on, and radiologic confirmation of, discogenic LBP. The treatments assessed included chemonucleolysis, surgical discectomy, and epidural steroid injection. A 26-point system to assess the quality of methodologic rigor was used for each article. Our literature survey found a need for additional studies comparing surgery, conservative care, epidural steroids, traction, and other approaches to determine their individual effects for RTW after discogenic disease.

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☆ No commercial party having a direct or indirect interest in the subject matter of this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

PII: S0003-9993(96)90147-1

Archives of Physical Medicine and Rehabilitation
Volume 77, Issue 11 , Pages 1189-1197, November 1996

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