Publication: Efectividad del ejercicio terapéutico en pacientes con hernia discal lumbar con radiculopatía asociada.
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2022
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Abstract
La hernia discal lumbar (HDL) representa el desplazamiento del disco más allá del espacio intervertebral. La HDL puede ser responsable de dar dolor lumbar y/o dolor de extremidad inferior. Este último puede acompañarse de características neuropáticas y definirse como dolor radicular. El dolor radicular se suele producir cuando el disco desplaza y comprime las raíces nerviosas espinales y se acompaña de inflamación intraneural. Actualmente, el manejo conservador se considera el tratamiento de primera elección, un ejemplo es el ejercicio terapéutico. Por ello, el objetivo de esta revisión sistemática es evaluar la efectividad del ejercicio terapéutico en la disminución del dolor, discapacidad y síntomas neuropáticos en pacientes con HDL con dolor radicular y/o radiculopatía asociada. La búsqueda se realizó en las bases de datos Pubmed, Cochrane Library y PEDro en febrero de 2022. De los estudios hallados, se seleccionaron nueve ensayos clínicos de los cuales se determinó su calidad metodológica y el riesgo de sesgo y se analizaron las características de la muestra. En cuanto a discapacidad todos los estudios mostraron mejoras significativas, cuatro estudios exhibieron diferencias significativas en el dolor lumbar, tres en dolor sin especificar y en dolor de pierna y dos respecto a síntomas neuropáticos. Los ejercicios de control motor obtuvieron mayores mejoras que el resto de los ejercicios. Sin embargo, la mayor parte de las mejoras fueron a corto plazo por lo que se necesitan más estudios con un mayor seguimiento. En conclusión, el ejercicio terapéutico ha mostrado ser efectivo para el tratamiento de HDL con radiculopatía.
Lumbar disc herniation (LDH) represents displacement of the disc beyond the intervertebral space. LDH may be responsible for low back pain and/or lower extremity pain. The latter may be accompanied by neuropathic features and be defined as radicular pain. Radicular pain usually occurs when the disc displaces and compresses the spinal nerve roots and is accompanied by intraneural inflammation. Currently, conservative management is considered the treatment of first choice, an example is therapeutic exercise. Therefore, the objective of this systematic review is to evaluate the effectiveness of therapeutic exercise in reducing pain, disability and neuropathic symptoms in patients with LDH with radicular pain and/or associated radiculopathy. The search was carried out in the Pubmed, Cochrane Library and PEDro databases in February 2022. Of the studies found, nine clinical trials were selected, of which their methodological quality and risk of bias were determined and the characteristics of the study were analyzed. sample. Regarding disability, all studies showed significant improvements, four studies exhibited significant differences in low back pain, three in unspecified pain and leg pain, and two in neuropathic symptoms. The motor control exercises obtained greater improvements than the rest of the exercises. However, most of the improvements were short-term, so more studies with longer follow-up are needed. In conclusion, therapeutic exercise has been shown to be effective for the treatment of disc herniation with radiculopathy.
Lumbar disc herniation (LDH) represents displacement of the disc beyond the intervertebral space. LDH may be responsible for low back pain and/or lower extremity pain. The latter may be accompanied by neuropathic features and be defined as radicular pain. Radicular pain usually occurs when the disc displaces and compresses the spinal nerve roots and is accompanied by intraneural inflammation. Currently, conservative management is considered the treatment of first choice, an example is therapeutic exercise. Therefore, the objective of this systematic review is to evaluate the effectiveness of therapeutic exercise in reducing pain, disability and neuropathic symptoms in patients with LDH with radicular pain and/or associated radiculopathy. The search was carried out in the Pubmed, Cochrane Library and PEDro databases in February 2022. Of the studies found, nine clinical trials were selected, of which their methodological quality and risk of bias were determined and the characteristics of the study were analyzed. sample. Regarding disability, all studies showed significant improvements, four studies exhibited significant differences in low back pain, three in unspecified pain and leg pain, and two in neuropathic symptoms. The motor control exercises obtained greater improvements than the rest of the exercises. However, most of the improvements were short-term, so more studies with longer follow-up are needed. In conclusion, therapeutic exercise has been shown to be effective for the treatment of disc herniation with radiculopathy.