Radicular pain is one disease that affects individuals of productive age between 20-60 years old. It can decrease one’s quality of life or work productivity.
Dr. Agus Yunianto, Sp.BS., said Hernia Nucleus Pulposus Lumbalis (HNPL) was a pain disease of the back often experienced by humans. It happened due to the protusion of discus intervertebra lumbalis that suppresses nerve roots, causing pain.
“Radicular pain will heal spontaneously or with a therapy,” he said on Wednesday during doctoral promotion (23/3) at Faculty of Medicine UGM.
The coordinator of nerve surgery unit at RSPAD Gatot Soebroto Hospital said only 10 percent of radicular pain need surgery. Therapy for HNPL is currenlty limited to remove the nucleus protruding.
“Despite the surgery to remove the discus protruding and release nerve roots, many patients complain of pain in the two year’s follow-up,” he said.
His research on 33 patients of HNPL at RSPAD Gatot Soebroto Hospital showed that the pain was not caused by the location of the HNP. Whether central or lateral does not make a difference in the pain significantly.
Other finding showed that the annulus fibrosus affects the pain score in patient of HNPL. Torn annulus causes more pain than annulus fibrosus which is intact.
Agus said the more severe the pain is, the higher mediator pro-inflammation IL-1β and TNF-α; besides, decrease in IL 1β level before and after surgery as compared to the level of TNF α. This happens particularly in acute patients with onset less than one month compared to onset more than one month. “IL-β can be made an indicator of pain severity in acute HNPL and as a predictor,” he said.