Postural Exercise as An Effective Tool for Pain Control in Patients with Low Back Pain: An X-Ray Imaging Study of Intervertebral Foraminal Changes
نویسندگان
1 School of Clinical Medicine, Shandong Second Medical University, Weifang, China
2 Department of Pathology, Dezhou People's Hospital, Qilu Hospital of Shandong University Dezhou Hospital, Dezhou, China
3 School of Clinical Medicine, Shandong Second Medical University, Weifang, China
4 Department of Spine Surgery, Dezhou People's Hospital, Qilu Hospital of Shandong University Dezhou Hospital, Dezhou, China
5 Department of Spine Surgery, Dezhou People's Hospital, Qilu Hospital of Shandong University Dezhou Hospital, Dezhou, China
6 Department of Spine Surgery, Dezhou People's Hospital, Qilu Hospital of Shandong University Dezhou Hospital, Dezhou, China
doi
10.22034/ircmj.2025.470520.1348چکیده
Background and Objectives: This study aims to evaluate the anatomical differences in the intervertebral foramina between healthy individuals and patients with simple low back pain using anterior-posterior (AP) and lateral X-ray imaging positions. Additionally, the therapeutic effect of postural exercises on these patients was assessed at different follow-up periods to evaluate the pain control effects of these exercises. Methods: The X-ray images of 30 healthy individuals and 30 patients with simple low back pain, who underwent lumbar hyperextension and hyperflexion X-ray scans, were retrospectively analyzed. The width, height, and area of the intervertebral foramina, as well as the ventral and dorsal heights of the intervertebral space at the upper and lower margins of the L3-4 and L4-5 intervertebral discs, were measured in normal subjects and pre-treatment patients, respectively. The patients were treated with postural exercises. Pain control was assessed using Visual Analog Scale (VAS) for pain, Oswestry Disability Index (ODI) for lumbar spine function, and Japanese Orthopaedic Association (JOA) score for the effect of the intervention. Results: The lumbar L3-4 and L4-5 intervertebral foramina were narrower in posterior extension and larger in flexion for patients compared to healthy individuals (P<0.01). The lumbar JOA scores of patients were 16.85±0.26, 20.74±0.27, 23.56±0.26, and 29.33±0.36 at 1 day before treatment, and 1, 3, and 6 months after treatment, respectively (P<0.001). The ODI scores at these time points were 24.80±0.48, 15.42±0.47, 8.47±0.44, and 2.60±0.36, respectively. The VAS pain scores were 6.33±0.14, 4.96±0.14, 2.11±0.22, and 1.11±0.16, respectively (P<0.001). Conclusion: The results of this study indicated significant anatomical vertebral differences between patients with chronic low back pain and healthy individuals. Furthermore, our findings demonstrated that postural exercise could improve patients’ disability, pain relief, and recovery. Over longer follow-up periods, patients showed increased lumbar JOA scores and decreased ODI and VAS pain scores, indicating greater therapeutic effects of postural exercises over time.
