Pain is defined as an unpleasant sensation occurring in varying degrees of severity.

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1 Jenna Williams Statistics 9:00am Project Abstract: Lumbar pain can be treated by various medical approaches, two of which include drug therapy and non-drug therapy. This study has been designed to test if there is a change in the level of pain a subject experiences based on which medical approach is chosen, drug therapy or non-drug therapy. The subjects were observed over a four week period, received a total of 2 treatments, and their pain level on a scale from 0-5 was assessed. The pain levels assessed and recorded each week were compared to the subjects initial pain level recorded on week one before any treatment was administered. The results showed there was no significant difference between the two medical approaches when helping with the level of lumbar pain experienced. Introduction: Pain is defined as an unpleasant sensation occurring in varying degrees of severity. Every individual will experience some kind of pain at some point in their life, whether it be mild, moderate, or severe. Pain is emotional as well as physical and can affect individuals in numerous ways. These include, feeling tired and lethargic, becoming depressed and anxious, and even feeling a sense of loss of control. Each individual will also find that a certain method of pain control will work better for them compared to other methods. This study is designed to see if there is a change in the level of pain a subject experiences based on which medical approach is used, drug-therapy vs. nondrug therapy. The area of pain being observed is low back or better known as lumbar pain. The data from this study comes from a clinic in Louisville, Kentucky that specializes in pain management. Method: Individuals experiencing lumbar pain between the ages of years old were

2 observed from two different groups, those who were receiving drug-therapy and those using a non-drug therapy treatment. In this experiment the group receiving drugtherapy consists of forty individuals who are receiving epidurals, which consist of a combination of drugs, including, a local anesthetic called Bupivacaine, an antiinflammatory medication called Depo-Medrol, and then a muscle relaxer, either Flexeril or Baclofen. The group using non-drug therapy treatment will also consist of forty individuals and they will be receiving Physical Therapy, during which the therapist may perform lumbar traction, heat and ultrasound therapy, and the use of a TENS (transcutaneous electrical nerve stimulation) unit, which is a device that sends electrical impulses to certain parts of the body to block pain signals. The subjects will be observed over a four week period, receiving a total of 2 treatments, and their pain level on a scale from 0-5 will be assessed, zero being no pain and five being the worst pain. Week one will begin with the subjects rating their level of pain before any treatment has been administered, followed by their first treatment. One week later, at the beginning of week two, the subject will be contacted with a follow up call to see what their level of pain currently is, compared to the previous pain level. Week three will begin in the same manner as week one, the level of pain will be assessed followed by the subjects second treatment, also followed by week four, a follow up call. The pain level assessed and recorded each week will be compared to the subjects initial pain level recorded on week one before any treatment was administered. To determine whether or not there was a change in the level of pain a subject experienced based on which medical approach was used, the pain levels will be grouped into four classes for each medical approach. The first class will be made up of subjects experiencing a change in their

3 pain between -3 and -5, which would indicate an excellent improvement. The second class will be made up of subjects experiencing a change in their pain between -1 and -2, which would indicate a moderate improvement. The third class will be subjects who experience no change in their pain, indicated by the class, zero. The forth and last class will be made up of subjects experiencing a change in their pain between 1 and 5, which would indicate that their level of pain became worse. This data will then be used to test if there is a difference between the two medical approaches by using the chisquare test of homogeneity. Analysis: After two weeks of observation, the pain levels recorded from week two s assessment were then subtracted from week one s assessment. The results show that overall about half of the subjects started showing progress, while the other half did not (Drug therapy; mean= , median= -1, std. dev. = 1.966; Non-drug therapy; mean= , median= -1, std. dev. = 2.337). However, the results showed there was no significance in using one medical approach versus using the other ( ²= 1.9, p-value= 0.59).

4 After three weeks of observation, the pain levels recorded from week three s assessment were also subtracted from week one s assessment. These results produced similar findings as the previous results. Again, overall about half of the subjects showed an improvement, while the other half did not (Drug therapy; mean= , median= -1, std. dev. = 2,218; Non-drug therapy; mean= -0.45, median= 0, std. dev. = 1.797). Yet again, the results were not significant ( ²= 3.0, p-value= 0.39). The final results were recorded after week four. Like the above assessments, the pain levels recorded from week four were subtracted from week one s assessment. In these results you will notice a difference from the previous results. This time over half of the subjects are now showing an improvement in their level of pain (Drug-therapy; mean= -1.75, median= -2, std. dev. = 1.736; Non-drug therapy; mean= , median= -1, std.dev. = 1.633). However, once again, the results showed no significant difference in using drug therapy vs. using non-drug therapy ( ²= 0.47, p-value= 0.93).

5 Conclusion: This study was designed to see if there is a change in the level of lumbar pain a subject experiences based on which medical approach is chosen, drug-therapy vs. non-drug therapy. After collecting data and testing it using the chi-square test of homogeneity it shows that there is no significant difference between the two medical approaches. Therefore, one approach does not help a subject more than the other approach, and its safe to say which ever approach is taken, it will produce similar results.