A study carried out in Australia has indicated that a course of customised physical therapy could be more beneficial in terms of lower back pain relief than simply general instruction on how to remain active.
Often patients suffering low back which persists after 6 weeks do not recover. The purpose of the study was designed to determine if patients with low bac disorders, receiving customised physiotherapy and guidance based advice demonstrated superior outcomes to those patients receiving advice alone.
The randomised trial made up of 300 patients who each received two guidance sessions, where they were given explanation on their source of discomfort and coaching in safe lifting techniques. In addition approximately half the cohort received ten personalised physiotherapy treatment sessions over a ten week period
The results indicated that the group receiving physical therapy showed significantly superior reductions in activity limitations over ten, twenty six, fifty two weeks, than the group which had received advice only. In terms of back pain the test group receiving physical therapy reported less back pain after five, ten, and twenty six weeks.
Jon Ford, the lead study author, at La Tobe University, Bundoora, Australia, commented that the findings implied that although advice is successful in many people, customised physiotherapy achieved a speedier reduction in pain and in the long term superior function and disability improvement
Ford and his colleagues stated in the British Journal of Sports Medicine that low back pain is one of the most common conditions that people would visit their doctor for, with many reporting persistent symptoms for over a year,
To qualify to participate in the study, patients needed to have exhibited pain for between six weeks up to six months and report one of five specific types of back pain: disc herniation, reducible disc pain, non-reducible disc pain, joint pain or multifactorial persistent pain.
Those patients receiving customized physical therapy within the study had specific exercise techniques tailored to their type of injury and individual barriers to recovery. For some, the focus would be on posture and lifting to ease disc pain, whilst others with disc herniation focused on motor control targeting specific muscle groups.
Both subsections of the 300 participating in the trial ie advice and the physical therapy groups improved over time, but those receiving customized exercise sessions generally did better.
The authors of the study did acknowledge however that the advice only group had far fewer encounters with health providers than the physical therapy group.
Steven George of the University of Florida commented that the fact that there was a difference of eight sessions between the treatment groups could account some of the group differences in results
Additionally, Julie Fritz, associate dean for research at the College of Health at the University of Utah in Salt Lake City, commented that the differences in outcomes between the two patient groups wasn’t that large, which is often the case in studies of back pain.
“Back pain is very common and many patients are advised to attend physical therapy at some point,” stated Fritz. “The challenge for researchers is to continue to examine which particular physical therapy interventions work for specific types of patients with low back pain and determine the optimal timing for physical therapy intervention.”
Source: British Journal of Sports Medicine October 20