Issue №1-89, 2019

Assessment of the efficiency of complex treatment with the application of rhythmic transcranial magnetic stimulation and general hydrohalvanical bathtubs in patients with lumbar and cross-radiculopathy

¹ Borodulina I.V., ¹ Badalov N.G., ¹ Mukhina A.A., ² Guscha A.O.

¹ «National Medical Research Center for Rehabilitation and Balneology», Moscow, Russia
² «Scientific Center of Neurology», Moscow, Russia

ABSTRACT

Lumbosacral radiculopathy due to degenerative disc disease is characterized by progressive neurological impairmentand increasing of the pain syndrome. The duration of the disease for more than 12 weeks leads to the development ofchronic radiculopathy. It has specific features and influences patients’ emotional condition, therefore reduces their adaptivecapacities and quality of life.For the moment, a lot of treatment methods and ways are developed but in fact they are insufficient to solve the problem.83 patients were included into the randomized comparative trial. They were allocated to the 2 groups: the 1st group ofactive treatment (42 patients) and the 2nd control group (41 patients). The patients of the 1st group received combined treatmentconsisted of repetitive transcranial magnetic stimulation of M1 area and general hydrogalvanic baths therapy. The controlgroup patients received medications (such as NSAIDs, myorelaxants, antidepressants). The evaluation was performed atthe baseline, at the end of treatment (14th day), and 3 months after the end of treatment. We used neurological examination,visual analogue scale (VAS), DN4, Pain DETECT, Beck Depression Inventory (BDI), Oswestry scale, Short Form 36 (SF–36). It wassignificant (p<0,05) improvement of sensory impairment at the active treatment group patients at the 14th day (hypesthesiafrequency reduced from 77% to 22%). This effect was not observed in the control group. The reduction of neuropathic painand depression was observed at both groups, the results were comparable. Analysis of long-term results showed that clinicalimprovement at the 1st group patients increases after 3 months in comparison with control group (p<0,05).Combined therapy including repetitive transcranial magnetic stimulation and general hydrogalvanic baths is effectiveand safe method of chronic lumbosacral radiculopathy treatment and could be used in the clinical practice.

KEYWORDS: lumbosacral radiculopathy, repetitive transcranial magnetic stimulation, hydrogalvanic baths, neuropathic pain.

References:

1. Podchufarova E.V. Diskogennaja pojasnichno-krestcovaja radikulopatija. Lekcija. Pervyj MGMU im I.M. Sechenova. S. 22-29.
2. Frymoyer J. Lumbar disc disease: epidemiology. Instr Course Lect 1992; 41: 217-23.
3. Cherkin D.C., Deyo R.A., Loeser J.D., Bush T, Waddell G. An international comparison of back surgery rates. Spine. 1994; 19: 1201-1206.
4. Health Council of the Netherlands. Management of Lumbosacral Radicular Syndrome (sciatica). The Hague: Health Council of the Netherlands; 1999.
5. Tian P., Li Z.J., Fu X., Ma X.L. Role of interleukin-17 in chondrocytes of herniated intervertebral lumbar discs./ Exp Ther Med.- 2015.- Vol.-10 (1). P.81-87.
6. Tarulli A.W., Raynor E.M. Lumbosacral Radiculopathy. Neurol Clin 25 (2007) 387-405.
7. Moore K.L. Clinically oriented anatomy. Baltimore (MD): Williams & Wilkins; 1992.
8. CHurjukanov M.V., SHvecova G.E., Zagorul’ko O.I. Neiropaticheskii komponent ljumboishialgii - mehanizmy razvitija i puti korrekcii. // ZHurnal nevrologii i psihiatrii.- 1.- 2017.- S. 90-96.
9. Campbell J.N., Meyer R.A. Mechanisms of Neuropathic Pain. Neuron. 2006; 52(1):77-92.
10. Cohen S.P., Mao J. Neuropathic pain: mechanisms and their clinical implications. BMJ 2014: 348.
11. Devor M., Rappaport H.Z. Pain and the pathophysiology of damaged nerve. In: Fields HL, editor. Pain syndromes in neurology. Oxford: Butterworth Heinemann; 1990.
12. JAhno N.N., Kukushkin M.L., Davydov O.S. i dr. Rezul’taty Rossijskogo jepidemiologicheskogo issledovanija rasprostranennosti neiropaticheskoi boli, ee prichin i harakteristik v populjacii bol’nyh, obrativshihsja k vrachu-nevrologu. Bol’. 2008; 3: 24-32.
13. Bolevye sindromy v nevrologicheskoi praktike / A.R.Artemenko [i dr.]; pod red. prof. V.L. Golubeva. - M.: MED- press-inform, 2010. - 336 s.
14. Kukushkin M.L. Diagnosticheskie i terapevticheskie podhody pri boli v spine //Lechashhii vrach. 2013. No5. - C. 11-13.
15. JAhno N.N. Hronicheskaja bol’: mediko-biologicheskie i social’no-jekonomicheskie aspekty. // Vestnik RAMN. - 2012. - No9. - C. 54-58.
16. Turk D.C., Okifuji A. Psychological factors in chronic pain: Evolution and revolution. // Journal Consulting and Clinical Psychology.- 2002.- 70.- 678-690.
17. Koes BW, van Tulder MW, Thomas S. Diagnosis and treatment of low back pain // BMJ. 2006. Vol. 332: 1430-1434.
18. Danilov A.B. Nejropaticheskaja bol’. // Klinicheskaja gerontologija.- 2.- 2007.- S. 27-36.
19. Syroechkovskaja M.N. Gidrojelektricheskaja vanna. // Voprosy kurortologii, fizioterapii i LFK.- 1961.- №5.- 447-450.
20. Gunther V, Mur E, Kinigadner U, Miller C. Fibromyalgia - the effect of relaxation and hydrogalvanic bath therapy on the subjective pain experience. Clin Rheumatol. 1994. Dec; 13 (4):573-578.
21. Muhina A.A., Badalov N.G., Artikulova I.N. Obshhie gidrogal’vanicheskie vanny v lechenii bol’nyh diabeticheskoi angiopatiei nizhnih konechnostei. Fizioterapevt. 2012; 8: 65-69.
22. Borodulina I.V., Badalov N.G., Muhina A.A., Gushha A.O. Gidrogal’vanicheskie vanny kak metod medicinskoi reabilitacii: obzor literatury i perspektivy klinicheskogo primenenija. Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kul’tury. 2018; 1: 49-56.
23. Nikitin S.S., Kurenkov A.L. Magnitnaja stimuljacija v diagnostike i lechenii boleznej nervnoj sistemy. Rukovodstvo dlja vrachej. M: SASHKO, 2003. 378 s. Andre-Obadia N, Peyron R, Mertens P, Mauguiere F, Laurent B, Garcia-Larrea L. Transcranial magnetic stimulation for pain control. Double-blind study of different frequencies against placebo, and correlation with motor cortex stimulation efficacy. Clin Neurophysiol. 2006; 117: 1536-1544.
24. Khedr EM, Kotb H, Kamel NF, Ahmed MA, Sadek R, Rothwell JC. Longlasting antalgic effects of daily sessions of repetitive transcranial magnetic stimulation in central and peripheral neuropathic pain. J Neurol Neurosurg Psychiatry. 2005; 76: 833-838.
25. Hosomi K, Shimokawa T, Ikoma K, Nakamura Y, Sugiyama K, Ugawa Y, Uozumi T, Yamamoto T, Saitoh Y. Daily repetitive transcranial magnetic stimulation of primary motor cortex for neuropathic pain: A randomized, multicenter, double-blind, crossover, sham-controlled trial. Pain. 2013; 154 (7):1065-1072.
26. Mogil JS, Max MB. The genetics of pain. In: McMahon SB, Koltzenburg M, editors. Textbook of pain. 5th ed. Elsevier: Churchill Livingstone. 2006; 159-174.

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Эта статья открытого доступа по лицензии CC BY 4.0. Издательство: ФГБУ «НМИЦ РК» Минздрава России.
This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.