Comparing Treatments after First-Time Disc SurgeryMany studies have been done to find a treatment that works for chronic low back pain. Researchers in this study turned their attention to treatment after first-time lumbar disc surgery. They compared two forms of treatment: usual care (UC), and treatment with a behavioral guided activity (BGA). Both treatments were delivered by physical therapists.
The patients were divided into two groups. The first group received UC, and the second was given BGA. All patients had the same number of treatment sessions. Physical therapists instructed patients in proper posture and lifting. Exercises were given to increase strength of the trunk muscles. Sometimes electrical therapy, massage, or manipulation was used. The goal was to decrease pain and muscle tone.
Each patient in the BGA group got a personalized exercise program. The goal was to increase activity while reducing fear of movement and avoidance behaviors. Everyone kept a cost diary for two periods of three months. Any money spent directly or indirectly was recorded. This included medications, equipment, health care, help from friends and family (paid or unpaid), and lost wages at work.
They found no difference in how well the two different treatments worked. The cost of the BGA was higher. The authors suggest there's no need to use BGA after lumbar disc surgery. Patients who receive BGA don't appear to get better than patients getting usual care, and BGA costs more.
Raymond W. J. G. Ostelo, PhD, PT, et al. Economic Evaluation of a Behavioral-Graded Activity Program Compared to Physical Therapy for Patients Following Lumbar Disc Surgery. In Spine. March 15, 2004. Vol. 29. No. 6. Pp. 615-622.
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