Research Paper Medical Science Volume : 5 | Issue : 6 | June 2015 | ISSN - 2249-555X

A Prospective Study of Lumbar Spondylosis Treated

With Short Wave Diathermy

Keywords Lumbar spondylosis, low back pain, short wave diathermy, degenerative spine

Dr. M. A. Q. Ansari
Associate Professor, Department of Orthopaedics, K.B.N. Institute of Medical Sciences, Gulbarga

ABSTRACT Lumbar spondylosis is a degenerative condition of the lower back and is the common cause of chronic
low back pain. A prospective study of 74 cases of chronic lumbar spondylosis patients was conducted
to find out the effectiveness of short wave diathermy. All patients were treated with short wave diathermy along with
conventional treatment. The result in terms of pain levels after treatment was compared with that before treatment. A
significant improvement was found, which suggest that short wave diathermy is effective for the treatment of patients
with chronic low back pain due to lumbar spondylosis.

I. Introduction  Presenting with chronic low back pain.

The term Spondylosis is derived from Ancient Greek ‘spon-
dylos’ meaning “a vertebra” and Spondylosis refers to de-
generative osteoarthritis of the joints between spinal ver-
tebrae. Hence Lumbar spondylosis can be defined broadly
as nonspecific degenerative condition of the spine. Its inci-
dence is increasing everyday due to lifestyle changes due
to industrialization1 and causing long term disability2. Back
pain which is present continuously for more than twelve
weeks is called chronic low back pain3. More than 75% of
all human beings have back pain at some point of their
lifetime because of their upright posture.4,5 Degenerative
changes are found in almost all aged persons.6
Apart from lumbar spondylosis, other causes of chronic
low back pain include lumbar disc disease in 5% cases7,
osteoporosis, infections like tuberculosis, tumors, fractures,
ankylosing spondylitis and rheumatoid arthritis. The other
associated risk factors include involvement in occupation
requiring forward bending, lifting heavy weight, exposure
to vibration caused by vehicles or industrial machinery8
The treatment of Low back pain due to lumbar spondylo-
sis needs multidisciplinary approach. Short wave diathermy
produces heat with deeper tissue penetration9 and is used
as modality of treatment in patients with chronic low back
pain. So this study was conducted to find out the effects
of short wave diathermy in the management of patients
with chronic low back pain due to lumbar spondylosis.
II. Materials And Methods
This is a study of 74 patients who presented to us with
chronic low back pain at our outpatient department. An
accurate history was taken and thorough physical exami-
nation done. Radiographic studies with plain X-ray of lum-
bosacral spine in both AP and lateral views were done to
see for useful confirmatory evidence and localize a degen-
erative lesion. Patients were diagnosed to have lumbar
spondylosis when their radiographs showed signs of de-
generation with absence of any other cause of low back
pain like a disc lesion. The patients were selected random-
ly, counselled and explained the various options of treat-
ment available to them and consent obtained for their in-
clusion in the study.
 Radiological features suggestive of lumbar spondylosis.
2.2 Exclusion criteria:
 The patients below the age of 45.
 Back pain of duration less than 12 weeks.
 Traumatic or inflammatory back pain.
 Lumbar disc lesion.
 Spina bifida
2.3 Treatment protocol: All patients were treated with
short wave diathermy in the low back region for 15 min, 6
times in a weak for four weeks. Non-steroidal anti-inflam-
matory drugs like diclofenac/aceclofenac/paracetamol or
muscle relaxants were given and therapeutic exercises with
activities of daily living instructions were prescribed to all
the patients enrolled in the study.
2.4 Follow up: The patients were followed up weekly for
4 weeks and outcome were recorded for pain by Visual
Analog Scale10,11 from 0–10 (0 = no pain and 10 = worst
possible pain).
III. Results
A total of 74 patients of lumbar spondylosis having chronic
low back pain were included in the study. These included
26 males and 48 female patients [Table 1]. The mean age
of the patients in study group was 64 ± 4 years. Most of
the patients in both males and females were found in the
age group of 65–74 years [Figure 1]. Mean duration of
symptoms was 28 ± 8 weeks. Most of the patients (88%)
had history of gradual onset of pain. Maximum patients
had pain of intermittent character (64%) while some (36%)
had continuous pain.
Table 1: Age and sex distribution of the study popula-
tion
Age Male Female Total (%)
45-54 05 11 16 (21.6)
55-64 08 14 22 (29.7)
65-74 10 18 28 (37.9)

≥ 75 03 05 08 (10.8)
2.1 Inclusion criteria:
 Patient of both sex and age above 45 years. Total 26 48 74 (100.0)

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 Research Paper
Figure 1: Age and sex distribution of the study cohort
There was significant improvement of VAS score with dura-
tion. It was observed that improvement of symptoms start-
ed at the end of first week of treatment and it gradually in-
creased every week [Figure 2].
Figure 2: Mean Pain scores during treatment.
At the end of the treatment there was highly significant
improvement in VAS score as compared to pre-treatment
score. This shows that treatment with SWD is helpful to the
patient with lumbar spondylosis having chronic low back
pain.
IV. Discussion
Lumbar spondylosis may not present a challenge to be
identified radiographically, but there remains a frequent
disconnection between the symptom severity and the de-
gree of anatomical or radiographic changes. Osteophyte
lipping along the posterior aspect of vertebral bodies,
along upper or lower margins, may impinge upon the neu-
ral structures. Hypertrophic changes to the superior articu-
lar process may intrude upon nerve roots within the upper
nerve root canal, dural sac or prior to exiting from next
lower intervertebral canal, depending on their projection.
While correlations between the number and severity of os-
teophytes and back pain exist, the prevalence of degen-
erative changes among asymptomatic patients underlies
the difficulty assigning clinical relevance to observed radio-
graphic changes in patients with LBP.
Factors increasing risk of spondylosis:
 Body mass index,
 incidental back trauma,
 daily spine loading (twisting, lifting, bending, and sus-
tained non-neutral postures),
 whole body vibration (such as vehicular driving),
 Genetic factors.
762 X INDIAN JOURNAL OF APPLIED RESEARCH
Volume : 5 | Issue : 6 | June 2015 | ISSN - 2249-555X
Management:
There is a little consensus with regard to a definitive treat-
ment approach. Substantial variation in management exists
between practitioners. The various modalities are as fol-
lows.
 Physical therapy – including Exercise therapy, Transcu-
taneous electrical nerve stimulation, Back school, Lum-
bar supports, Lumbar Traction, Massage therapy etc.
 Pharmacotherapy – includes NSAIDs, Opioid medica-
tions, Antidepressants and Muscle relaxants
 Injection therapy - Epidural steroid injections and Facet
injections
 Surgical options - reserved for patients who have failed
conservative options and include spinal fusion or spine
decompression.
Rahman et al. conducted a comparative study in patients
of spondylosis, and concluded SWD to be an effective
treatment12. Chard and Dieppe13 suggested that the use of
non pharmacological intervention like SWD is an essential
part of the treatment in osteoarthritis.
Lunda and Bombarien14 acknowledged the use of elec-
trotherapeutic and thermal modalities in management of
chronic low back pain. Gibson et al studied 109 patients
and observed that 59% patients improved after treatment
with short wave diathermy15. Bansil et al found SWD to be
effective in the treatment of osteoarthritis of knee joint16.
Rahman MM in 1999 analysed 342 cases of low back pain
and found that 77.42% of patients were improved after
the treatment with short wave diathermy17. Shakoor et al.
found significant improvement after SWD in patients with
cervical spondylosis presenting with neck pain18.
Conclusion
Despite high prevalence of low back pain within the gen-
eral population, the diagnostic approach and therapeu-
tic options are diverse and often inconsistent, resulting
in rising costs and variability in management. There is no
gold-standard treatment approach to the diverse range of
patient presentations despite substantial research in this
area. This prospective study showed that short wave dia-
thermy is an effective modality of treatment as an adjuvant
to NSAIDs, in the management of the patients with lumbar
spondylosis having chronic low back pain.
Acknowledgement
We like to thankfully acknowledge the sincere efforts of
our physiotherapist Mr. Akbar Ali who contributed the
treatment to our patients as per the given protocol and
provided timely feedback.
Research Paper Volume : 5 | Issue : 6 | June 2015 | ISSN - 2249-555X

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