A Comparative Analysis between Short Wave Diathermy and Infrared Radiation’s Effects on the Patients with Chronic Low Back Pain \r\nDue to Lumbar Spondylosis\r\n

Introduction: Low back pain is a symptom and not a disease.The low back pain is considered to incorporate dorsal painfound any place between the 12 thoracic vertebra and lowerbuttock up to gluteal folds or anus. Lumbar spondylosis is atypical reason for chronic low back pain and chronic disability.Objective: The main purpose of this research is to give acomparative analysis between short wave diathermy andinfrared radiation for treating lower back pain caused byspondylosis.Method: This was an observational study. A randomizedclinical trial study was conducted on Department of PhysicalMedicine and Rehabilitation, BSMMU, Shahbagh, Dhaka on153 patients who came to hospital with lower back pain andsuffered from spondylosis. The study duration was from 1stMarch 2010 to 15 September, 2010.Results: Out of 153 patients, irrespective of sex, it was foundthat most of the patients (50.98%) belong to 40-49 years agegroup followed by: 50-59 years (27.45%), 30-39 years(11.11%) and 60-70 years (10.46%) age group. in 72.2%patients prolonged sitting exacerbate the lower back pain.Prolonged standing was also found as another aggravatingfactor of pain among the study patients (17.6%). Prolongedwalking (5.9%) and leaning forward (3.3%) came next in theorder of aggravating factors for lower back pain. The study alsoshowed the performance difference between SWD and IRR onthe patients.Conclusion: Considering the information gathered from thisstudy, it can be concluded that all the tested therapies seemedto improve the patients with chronic low back pain. But IRR andSWD showed no significant difference in improvement for thepatients with chronic LBP due to lumbar spondylosis.

Effects of activity modification on the patients with osteoarthritis of the knee.

A prospective randomized clinical trial was conducted on 162 patients of osteoarthritis of knee were included in the study. The patients were divided into two groups- Group A and Group B. The Group A was treated with shortwave diathermy, exercise, naproxen and activity modification and the Group B was treated with shortwave diathermy, exercise and naproxen. Improvement was found more in Group A than Group B after 4th week (95% CI was -2.59 to 6.56). Then it was found that the improvement was gradually increased in Group A than Group B and finally, it was found that there was highly significant improvement in Group A than Group B after 6th week (95% CI was -3.45 to -0.70). This study suggests that activity modification play an important role for the treatment of the patients with osteoarthritis of knee.

Endometriosis association research center.

Endometriosis, the presence of endometrial tissue outside the uterus, is a progressive, estrogen-dependent disease and occurs nearly exclusively in menstruating women of reproductive age. Pain syndrome, however, represents the major clinical problem of this disease, manifested as dysmenorrhea, pelvic pain, lower abdominal pain, and dyspareunia. About 32 literatures are reviewed in recent advancement for diagnosis of endometriosis. The magnifications of its managements are understood. In outdoor, the management is only depending on clinical findings and on some non invasive procedures without any definitive diagnosis. So, research activities should be done on the basis of recent advancement of endometriosis.

Arthrographic distension of the shoulder joint in the management of frozen shoulder.

The study was an open randomized controlled trial to compare the outcome at 8 weeks with two different modalities in the treatment of 'Frozen shoulder'. Clinical cases with painful limitation of movement of shoulder were randomized to receive physical therapies alone versus physical therapies and shoulder arthrography with intra-articular steroid in a sequential randomization process. Cases suspected of having a concomitant illness and has potential to cause secondary frozen shoulder were excluded, such as, history of trauma to shoulder over the last 6 months, symptomatic clinical cervical degenerative diseases, and causes in and around the shoulder (infective and non-infective). Physical Therapies provided to all patients were therapeutic exercises, transcutaneous electrical nerve stimulation (TENS) and infra-red radiation (IRR). Outcome measures were improvement of pain on a Visual Analogue Scale (VAS) score and range of motion measured by Goniometer at 8 weeks. Patients were followed weekly for 8 weeks and outcome parameters were recorded on every evaluation. The baseline range of motion in the two groups was comparable. At 8 weeks a statistically significant difference in outcome were observed in the two groups. The chi-square means difference of improvement in range of motion for abduction was p <0.00 and for external rotation was p <0. 00. The pain reduction on VAS score was not significant in the two groups (p <0. 40). In the present small series, the distension arthrography with intra-articular (IA) steroid plus physical therapy was superior over physical therapy alone in the functional improvement of the frozen shoulder. Further studies with larger sample size are required to confirm the observations.

Effects of cervical traction and exercise therapy in cervical spondylosis.

A randomised clinical trial was conducted in the Department of Physical Medicine, Chittagong Medical College Hospital from July, 2001 to June, 2002. The objectives of the study were to find out the effects of cervical traction (CT) and exercise on the patients with chronic cervical spondylosis. A total of 199 patients with cervical spondylosis were included in the clinical trial. One hundred patients were treated with cervical traction plus exercise and 99 patients were treated with non-steroidal anti-inflammatory drug (NSAID). Posture correction advice was given to all patients. The patients were treated for 6 weeks. There was a marked improvement in both the groups after treatment (P<0.001). But there was nearly significant difference regarding improvement in treatment with CT plus exercise than with NSAID (P = 0.06). The results indicate that the improvement of the patients with chronic cervical spondylosis was more in CT plus exercise than analgesics. So, CT & neck muscle strengthening exercise may have some more beneficial effects than NSAIDs on chronic cervical spondylosis.