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BACKGROUND: Although many studies have investigated the physical and ergonomic risks of spine pain in specific occupation groups, the literature is lacking on occupation-based clinical and psychological presentation in patients with spine pain. OBJECTIVE: To analyze occupation-based variation in demographic, clinical, and psychological presentation in patients with spine pain. METHODS: This retrospective study analyzed the clinical data of 71727 patients with spine pain visiting a chain of spine rehabilitation clinics. Demographic and clinical variables such as gender, age, affected site, symptom duration, clinical symptoms and presentation, pain intensity, disability, and STarT Back Screening Tool (SBT) risk were compared between 9 occupational groups. RESULTS: The service and sales workers (44%) and students (43.5%) groups had the highest percentage of patients who presented with central spine pain; military personnel had the highest percentage of patients who presented with unilateral radicular pain (51.5%); and the retired or unemployed group had the highest percentage of patients who presented with severe myotomal loss (grade≤3) (6%). Homemakers had significantly higher pain intensity and disability (p < 0.001) and had the highest percentage of patients who presented with severe pain (47%), severe and crippled disability (59.5%), and medium to high risk (59%) with SBT when compared to other occupational groups. CONCLUSION: Patients with spine pain showed variation in demographic, clinical, and psychological presentation based on their occupation. The findings of this study can be the basis for identifying risk factors for spine pain and helping plan preventive and treatment measures based on their occupation. [ABSTRACT FROM AUTHOR]

Background: The most prevalent disorder affecting the spinal cord is lumbar radiculopathy. The incidence of this condition is estimated between 3% and 5% of the population and it impacts both male and female equally. The goal of this present study is to compare the effectiveness of dry needling to interferential therapy [IFT] in terms of reducing pain and increasing the lumbar range of motion in patients with lumbar radiculopathy. Purpose: To determine the effect of dry needling on patients with lumbar radiculopathy in reducing pain and increasing lumbar ROM compared to interferential therapy. Materials and Methods: 30 subjects participated and pre assessment and post assessment was taken using Numerical Pain Rating Scale [NPRS] and the Modified-Modified Schober Test [MMST]. For both groups, the intervention period lasted for 2 weeks and the entire study procedure was carried out from November 2022 to April 2023. Result: This study showed an extremely satisfied statistical significance difference between post-test values of both groups (p<0.0001). However, the experimental group showed substantially greater statistical significance than the control group in terms of the decrease in pain levels and the increase in lumber ROM. Conclusion: The study concluded that intervention provided to the experimental group was more effective than intervention provided to the control group. [ABSTRACT FROM AUTHOR]

Background: Lumbar radiculopathy is a term used to describe a range of symptoms that includes pain, tingling, numbness, and weakness that spreads along the pathway of the sciatic nerve. This condition can arise when any of the five sciatic spinal nerve roots become compressed or irritated, affecting one or both lower limbs. Purpose: The study is to compare the effectiveness of McKenzie exercises and the neural flossing technique in managing lumbar radiculopathy in patients. Methodology: The study recruited 40 participants with lumbar radiculopathy, randomly allocating them to Group A (McKenzie exercises along with laser therapy) and Group B (neural flossing with low-level laser therapy). The modified Oswestry Disability Index and Numeric Pain Rating Scale were used to assess outcomes. Results: The results showed that the neural flossing technique (Group B) demonstrated statistically significant improvements in reducing pain and improving function compared to the McKenzie exercises (Group A) post-treatment. Group B had significantly lower NPRS scores (p < 0.0001) and a higher improvement in MODI scores compared to Group A. Conclusion: In this study, the neural flossing technique (Group B) showed superior outcomes in managing lumbar radiculopathy compared to McKenzie exercises (Group A). Group B exhibited significantly lower pain levels and greater improvement in functional disability. These findings suggest that the neural flossing technique may be a more effective treatment option for patients with lumbar radiculopathy. [ABSTRACT FROM AUTHOR]

Background: Cervical radiculopathy, commonly called a "pinched nerve," occurs when a nerve in the neck is irritated or compressed where it branches away from the spinal cord concerning particular neurologic and musculoskeletal conditions in the neck and upper limbs. Fifty-nine percent of work-related musculoskeletal disorders are reported annually by information technology (IT) professionals, among which 30% are neck pain-related disorders. Thus, this study aims to know the prevalence of cervical radiculopathy among IT professionals with neck pain. Aims: The aim of this study was to find out the prevalence of cervical radiculopathy among IT professionals with neck pain. Objectives: The objective of this study was to establish the relationship between cervical radiculopathy and neck pain and to find out the percentage of disability by using the Neck Disability Index (NDI). Materials and Methods: The prevalence study was carried out with a sample size (n = 92) involving IT professionals in Bangalore. The NDI questionnaire (NDI) related to daily life activities was used. To identify cervical radiculopathy, specialized testing was performed. Results: Out of 92 samples, 46 tested positive for cervical radiculopathy, showing a prevalence of 50%. Cervical radiculopathy was more prevalent among males than females. There was a difference (P < 0.05) in neck disability according to a special test. Conclusion: This study provides evidence for the prevalence of cervical radiculopathy among IT professionals with neck pain with a positive correlation with gender and working hours per day. [ABSTRACT FROM AUTHOR]

Background and Objectives: Low back pain with radicular symptoms is a prevalent musculoskeletal disorder and a leading cause of disability. Radicular back pain affects multiple nerve roots, resulting in pain, sensory loss, and motor dysfunction. Assessing the quality of life (QOL) provides valuable insights into the impact of health conditions and treatment outcomes. Low back pain significantly interferes with QOL and work performance. This study aimed to analyze the QOL in female patients with low back pain and radiculopathy. Materials and Methods: An observational study was conducted on 404 patients and healthy individuals at a medical college in India. The SF-36 questionnaire, which measures eight scores representing physical and mental components, was used to assess QOL. Results: Results from 364 eligible patients revealed significantly lower mean PCS and MCS scores compared to the normative population, indicating poorer QOL among low back pain patients. Conclusion: In conclusion, patients with low back pain and radiculopathy experience a diminished QOL compared to individuals without this condition. Therefore, efforts should be made to enhance patient care, focusing on improving QOL, as this aspect remains relatively unexplored. [ABSTRACT FROM AUTHOR]

Introduction: Despite numerous investigations has delved into Non invasive Neuromodulation (NINM) for alleviating neuropathic pain from various origins, its efficacy in addressing radiculopathic pain specifically remains inadequately explored. Aim: To comprehensively synthesise existing literature on the use of NINM in managing radiculopathy-induced pain. Materials and Methods: A thorough search of four databases— Scopus, PubMed, Physiotherapy Evidence Database (PEDro), and Cochrane Library was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines from October 2023 to January 2024. Included articles in the study must have patients with cervical or lumbar radiculopathy, aged over 18 years, and included atleast one non invasive neuromodulation intervention, with outcomes measuring pain. Case reports, reviews, and meta-analyses were reviewed for additional references. “Radiculopathy” and “Neuromodulation” were Sidharth Bansal, Postgraduate Student, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India. Nidhi Sharma, Professor, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India. Simranjeet Kaur, Assistant Professor, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India. Exploring Non invasive Neuromodulation to Ameliorate Radiculopathic Pain- A Systematic Review of Randomised Controlled Trials Abstract ID: PG-65 the primary keywords used to extract data and the studies’ quality and findings were critically appraised using tools such as PEDro, Grading of Recommendations, Assessment, Development and Evaluations (GRADE), Level of Evidence, and Risk of Bias. Results: Six out of 75,182 studies that were identified met the inclusion criteria and underwent thorough evaluation. The remaining 75,176 articles were excluded for reasons such as duplicates (32,156), patients not related to radiculopathy (15,637), lack of the desired intervention or outcome (27,094), and various other reasons (289). NINM methods showed a significant reduction in pain severity for radiculopathy patients, with no reported adverse effects. Conclusion: In summary, integrating NINM approaches alongside conventional therapeutic strategies showed promising effects in enhancing the efficacy and sustainability of pain management for radiculopathy. [ABSTRACT FROM AUTHOR]

Introduction: Cervical radiculopathy is the clinical condition when a nerve root in the cervical spine becomes inflamed or damaged due to compression because of various reasons resulting in a change in neurological function. Kinesio taping is a treatment method used by physical therapists to improve symptoms associated with musculoskeletal disorders. It can be stretched to 140% of its original length before being applied to the skin. It subsequently provides a constant pulling (shear) force to the skin, unlike traditional athletic tape. Aim: To study the effect kinesio taping on pain, neck disability and physical function of upper limb in cervical radiculopathy. Materials and Methods: This longitudinal study was carried out at SGT Hospital Gurugram, Hrayana, India, between February 2018 to August 2018. Fifty subjects, aged 18-50 years with positive response for the 4 test item cluster described by Wainner RS et al., were included in the study and were given manual therapy treatment, cervical stabilisation exercises and kinesio taping. There were three sessions per week for a total of four weeks. Neck Disability Index (NDI), Numeric Pain Rating Scale (NPRS) and Disability of the Arm, Shoulder and Hand (DASH) questionnaire were the outcome measures. The readings were noted at prelevel (0 week), mid-levels (at 2 weeks weeks) and at post-levels (at 4 weeks weeks). Comparison of different values was done using paired t-test. Level of significance was taken at p-value <0.05. Results: The mean age of patients was 48.1±11.9 years. The NDI scores at 0 weeks, at 2 weeks, at 4 weeks were 46.00±4.96, 30.48±4.56, 14.84±3.94, respectively. The DASH scores at 0 weeks, at 2 weeks, at 4 weeks were 59.52±7.55, 34.49±8.70, 0.74±0.69, respectively. The NPRS scores at 0 weeks, at 2 weeks, at 4 weeks were 8.72±0.7, 5.10±1.07, 0.74±0.69. All the variables showed significant improvement between different intervals. Conclusion: Kinesio taping method along with manual therapy treatment, cervical stabilisation exercises was effective in treating patients with cervical radiculopathy. [ABSTRACT FROM AUTHOR]

Background: McKenzie back extension exercises from prone position has been widely prescribed for patients with lumbosacral radiculopathy (LSR). It has been reported to reduce radicular symptoms. Such reduction might indicate that decompression effect of this exercise on the compromised nerve root. The aim of this study was to evaluate the effect of McKenzie back extension exercise from prone position on soleus H-reflex of patients with LSR. Patient and Method: Seventeen male and Thirteen female patients (46.27±10.13 years) with confirmed chronic unilateral LSR participated in the study. All patients had done thirty repetitions of McKenzie back exercise from prone position. The soleus H-reflex was measured before and after the exercise. The Hreflex was elicited by electrical stimulation of the tibial nerve on the popliteal fossa of each legs. The non-involved leg of the patient was used as a control. Subjective pain intensity and sit-to-stand performance were additionally measured before and after back extension exercise using numerical pain analog scale and a stopwatch respectively. Results: The H-reflex latency within the affected leg showed significant difference after the exercise (p <0.05). The pain intensity and the sit-to-stand test had shown significant changes following exercise (p < 0.05). Conclusion: This study could indicate that the McKenzie repeated back extension exercises the manner performed in this study had improved the H-reflex, pain intensity or functional level of the patients. [ABSTRACT FROM AUTHOR]

Oral cancer is the second most common cancer in India, with squamous cell carcinoma (SCC) noted in 90% of cases. Distant metastasis (brain metastasis) from oral SCCs is rare. The incidence of intracranial metastasis is about 0.4% and 2%–8% and approximately 5% to 10% of all cancer patients develop spinal metastasis. However, vertebral metastasis is rare form of distant metastasis from SCC of the oral cavity. Multifocal metastases to the brain and spine of primary oral squamous cell carcinomas have not been reported till date which prompted us to report this case. A 35-year-old male with a history of radical resection done for SCC of the buccal mucosa followed by postoperative chemoradiotherapy presented with complaints of headache and convulsions accompanied by severe low backache and left lower limb radiculopathy with no motor or sensory deficit. Positron-emission tomography scan showed increased uptake in the left frontal lobe and in the dorsal and lumbar spine suggestive of metastasis. Magnetic resonance imaging of the brain and spine with contrast was done which showed a well-defined lesion in the left frontal lobe and contrast-enhancing lesions L5, L2, and T5 vertebra levels. Craniectomy with gross total excision of the left frontal lobe lesion was done. Histopathological examination was suggestive of metastatic SCC. The patient was advised for follow-up for spinal decompression followed by radiotherapy. We need to have a high index of suspicion for metastasis in brain and spine lesions in patients who have been diagnosed previously with oral malignancies for prompt management and better life expectancy. [ABSTRACT FROM AUTHOR]

Cervical radiculopathy is a neurological condition characterized by the dysfunction of a cervical spinal nerve, nerve root or both. Neural mobilization uses the specific position and movements of neck and arm to reduce nerve mechanosensitivity, resolve symptoms and restore function. Studies have shown that cervical traction is effective in relieving radiating pain and its associated disability and a few studies have shown that neural mobilization provides immediate benefits without harmful effects. Objectives: To compare the effectiveness of neurodynamic treatment and intermittent cervical traction in cervical radiculopathy. Methodology: Thirty subjects aged 18-70 years, both gender with unilateral upper extremity pain, paresthesia or numbness, 4 positive findings:- positive Spurlings test and distraction test and upper limb tension test, <60 degree ipsilateral cervical rotation were recruited for this pilot interventional study. Selected subjects were equally divided and randomly allocated two experimental group:- Group A and B by chit pick method. Group A received intermittent cervical traction, myofascial release(MFR), strengthening to deep flexor muscles of neck and scapulothoracic muscles while Group B received Neurodynmic treatment (NDT), MFR, strengthening for deep flexor muscles of neck, and scapulothoracic muscles. Outcome measure used was Neck disability index (NDI) before treatment and after one week treatment. Results: Statistical analysis of mean difference of pre and post disability was done by paired t-test and comparison of effect of treatment between 2 groups by students t test. The results have showed that there is high significance (p< 0.05) between two groups. Conclusion: Findings of this pilot study shows that there was high significant difference between both group treatment. This study concluded that NDT was more effective in management of cervical radiculopathy along with MFR and strengthening in reducing pain and improvement in neck function. [ABSTRACT FROM AUTHOR]

Context: The α2δ modulators gabapentin and pregabalin are effective against neuropathic pain. Numerous brands of α2δ modulators are available in India, and are expected to have equivalent clinical effects. They are routinely used for management of neuropathic pain associated with radiculopathy. Aim: To describe clinical outcomes in three series of cases of neuropathic pain treated with three available brands of α2δ modulators. Settings and Design: Retrospective analysis of clinical outcomes in patients attending an interventional pain clinic Patients and Methods: One hundred and ninety-four consecutive patients with neuropathic pain secondary to Magnetic Resonance Imaging (MRI)-documented compression radiculopathy received either LYRICA (LYR), a locally available generic brand of pregabalin (PGN), or a locally available generic brand of gabapentin (GBN), respectively. Drug treatment was continued till adequate pain relief was achieved. In each of the three groups, mean pain scores were analyzed at Days 0, 15, 60 and 90, and daytime sedation scores at Days 1, 15, 60 and 90. Statistical Analysis used: Analysis of variance (ANOVA) followed by pair-wise comparison using two-tailed unpaired t-test (if P value was significant). Results: Mean pain score was significantly lower in the LYR series as compared to the PGN and GBN series at Days 15, 60 and 90. As compared to the PGN and GBN series, a greater proportion of patients in the LYR series could discontinue drug therapy following adequate pain relief, by Day 90. Daytime sedation scores were significantly lower in the LYR series as compared to the PGN and GBN series at Days 1, 15 and 60, and as compared to the PGN series at Day 90. Conclusion: These results indicate the effectiveness of α2δ modulators for management of neuropathic pain secondary to compression radiculopathy. The results also suggest a possible therapeutic superiority of LYRICA over locally available generic brands of pregabalin and gabapentin. These findings need to be further examined in randomized, controlled trials. [ABSTRACT FROM AUTHOR]

Endemic skeletal fluorosis is widely prevalent in India and is a major public health problem. The first ever report of endemic skeletal fluorosis and neurological manifestation was from Prakasam district in Andhra Pradesh in the year 1937. Epidemiological and experimental studies in the endemic areas suggest the role of temperate climate, hard physical labor, nutritional status, presence of abnormal concentrations of trace elements like strontium, uranium, silica in water supplies, high fluoride levels in foods and presence of kidney disease in the development of skeletal fluorosis. Neurological complications of endemic skeletal fluorosis, namely radiculopathy, myelopathy or both are mechanical in nature and till date the evidence for direct neurotoxicity of fluoride is lacking. Prevention of the disease should be the aim, knowing the pathogenesis of fluorosis. Surgery has a limited role in alleviating the neurological disability and should be tailored to the individual based on the imaging findings. [ABSTRACT FROM AUTHOR]