Thursday, April 26, 2007

Low Level Laser for Hernia Nucleus Pulposes (HNP)


May I introduce : mr Hamid Supriyanto
He is 53 years old, father of 5 children, 2 boys and 3 girls

Mr . Hamid's story:
Hospitalized due to very severe sciatic pain , after gardening.
Mr Hamid diagnose as Hernia Nucleus Pulposes (HNP) ; L 2,3,4 and 5. Refused to surgical approach.



Yes, Sir. Your problem is common to middle-age man, especially after strenuous activity. You did gardening, and pulled bushes . Your roentgens shows bulging at L2. 3.4 and 5. the pain radiated to your buttock, posterior thigh , and lateral calf. It follows the path of sciatic nerve .





Therapy began with totally bed rest due to your pain (vas almost 10). Modality TENS to reduce the spasm. But after almost 3 weeks, your pain still above 6, laser is the answer. First with transcutaneus approach, 30 minutes. The pain still annoying, although you could ambulation using lumbosacral corset and cane. It was comfort for your at 1 hours therapy .

So , I decided to used ILIB, given twice a week. The pain gone after the 4th ILIB, walking freely , erect , without cane, after 5th therapy, and your daily activity full recovery. (You do gardening and riding your motorcycle).





Although we are lying supine in bed, it is not free .
The load will be 100 % during upright position.

Discussion:

Yet laser is the main modality for your problem, but bed rest, TENS , and avoid weight using lumbosacral corset have the portion.

Along with laser ubi quinon , and neurotropic agent . Ubi quinon works at mitochondria as well as the laser. Neutropic agent for nerve healing conjunctions with laser.

Figure above demonstrates relative changes in L3 disk pressures in various position . Although in lying position, no weight free. In patient with HNP, lumbosacral orthose reduces or avoid weight , so no nerve impingement .

ILIB more forceful than transcutaneus. As the results, your pain reduced faster.