Management of symptoms for persistent lumbar disc herniation with radiculopathy
Patients who still suffer from neurological deficits three months after their injury should be referred to their physician for further evaluation
Adults with lumbar disc herniation with radiculopathy
Conduct an appropriate clinical evaluation
Risk factors for serious pathologies?
Poor prognostic factors?
Offer information on nature, management, course of the back pain as a framework for initiation of a program of care
Is treatment required?
Are symptoms ≤3 months?
Management of Symptoms
Based on shared decision making between the patient and provider, any one of the following therapeutic interventions is recommended:
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Refer to appropriate services
Go to appropriate clinical care pathways and co-manage
Are symptoms >3 months?
Refer to medical physician for consideration of further investigation of the neurological deficits
Adjust modifiable prognostic factors
Is the person recovered after 3 months?
Incomplete recovery: Initiate persistent protocol
Major symptom change (new or worsening physical, mental or psychological symptoms): refer to physician
Literature search updated April 2015