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21 Treatment failure correlated with degenerative lesion origin, longer symptom duration, larger lesion size, older age, and prior knee surgery

Herniated disc Lumbar spinal stenosis Facet joint arthritis Sacroiliac joint dysfunction Peripheral neuropathy or vascular claudication Common treatments include: Medications: Anti-inflammatory drugs, pain relievers, or muscle relaxants

However, the ordinal association of the change in PHES scores during sequential visits (e.g., baseline, week 12, and week 24) among patients with minimal HE diagnosed at the baseline was significantly improved within the L-carnitine group ( p = 0.007) (Fig