Clinical Question: Do patients with...

Clinical Question: Do patients with back pain who bear physical therapy benefit more than those simply given advice to remain active?

Setting: Outpatient (specialty)

reflection Design: Randomized controlled trial (single-blinded)

Allocation: Concealed

Synopsis: Investigators started with 286 patients with gentle back pain in the United Kingdom who were referr from their general practitioner or a subspecialist for physical therapy. The patients were invited to participate in the meditation and were randomized (allocation assignment was concealed) to receive a booklet from a physical therapist advising them to remain active or the booklet plus six treatment sessions of physical therapy using joint mobilization and manipulation, plastic tissue techniques, and strengthening exercises. Analysis was by the agency of intention to treat, although follow-up after united year was only 70 percent Approximately 10 percent of the patients randomized to receive advice-only also received physical therapy.

The primary issue was the change in the Oswestry Disability Index, a scale complet by dint of patients that ranges from nothing percent (no disability) to 100 percent (totally disabled). of the same heights of disability were similar single year after treatment assignment. Quality-of-life scores were the same at individual year as measured by the 36-item Short-Form Health examine Patients reported significantly more benefit at pair and six months if they received physical therapy, yet it is very possible--given that patients were aware of their treatment--that this finding throw backs a placebo effect. Other research also has not shown a benefit of physical therapy for low-back pain (Fritz JM et al. Comparison of classification-based physical therapy with therapy based forward clinical practice guidelines for patients with acute cheap back pain: a randomized clinical trial. Spine July 1 2003;13:1363-72)

Bottom Line: Physical therapy sessions do not propound additional long-term benefit over simple advice to remain active in patients referr for physical therapy. Patients initially perceive a benefit while being treated, nevertheless this benefit disappears by single in kind year. (Level of Evidence: 2b)

close attention Reference: Frost H, et al. Randomised controll trial of physiotherapy compared with advice for grave back pain. BMJ September 25 2004;329:708-11

Used with permission from Shaughnessy AF. Physical therapy adds little to back pain treatment. Accessed online November 24 2004 at: http://www.InfoPOEMs.com.

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