SAT0296 Patients with diffuse idiopathic skeletal hyperostosis and low back pain – evaluation and rehabilitation

Background Diffuse Idiopathic Skeletal Hyperostosis (DISH) generally occurs in people between the ages of 50 and 60, more often in men than women. Physical therapy and kinetic program may help delay the loss of motion in affected joints and control the low back pain (LBP). In most cases of DISH with LBP, certain muscles of the back that stabilise the spine are reflexively inhibited and do not spontaneously recover even if patients are pain free with a return to normal activity levels. Objectives In our observational study we evaluated the role of rehabilitation program in quality of life and assessed the thickness of the erector spinae (ES) muscle in these patients and to evaluate the correlation between thickness difference in three different trunk postures and functional parameters. Methods 38 male patients (61.5 years mean age) with DISH and LBP were enrolled in this study. Frontal (AP) and lateral lumbosacral regions were radiological evaluated. Clinical and functional parameters were collected by a physiotherapist, that applied rehabilitation program (12 sessions of TENS, interferential current, ultrasound, aerobic training) and an US examination was performed by a physiatrist within 72 hours of the clinical examination. We performed ultrasonography to measure the thickness of the ES muscle at L4 and L5 level in maximum flexion, neutral posture, and maximum extension. All collected clinical and imagistic data were statistical analysed, pre-post rehabilitation. Results Multivariate analysis showed that thickness differences between flexed and neutral, and flexed and extended maximally positions were correlated statistically with functional parameters (VAS and The Roland-Morris Disability Questionnaire score). We obtained a significant improvement in VAS (p Conclusions Although ossification in DISH generally affects the ligament of the spine, pain is more likely to arise in correlation with the erector vertebral muscle status. Visual observation of the image during contraction indicates that US may be a valuable biofeedback tool. Kinetic program (regular exercises that strengthen spine, walking and global stretching), avoiding sitting position for long periods of time, sleep on a correct mattress and optimal daily activities are the most important recommendations for all patients with DISH. Disclosure of Interest None declared