Treatment of Non-Specific Low Back Pain
Low back pain is considered one of the leading causes of functional limitation and work restriction throughout the world. Research has indicated that a subset of patients (~50%) do no improve within the first 12 weeks of treatment and therefore become re-classified as “chronic”. Current literature supports the use of both education/ advice as well as conventional physiotherapy (manual therapy and exercise). However, no reviews to date have directly compared the two treatment modalities. With this in mind, the authors carried out a current systematic review, and found that there were mixed results in favor of exercise versus advice. Two studies showed favorable results of exercises versus advice, one study was in favor of advice versus exercise and one showed no difference.
A literature review was carried out on six databases: MEDLINE, EMBASE, CINAHL, AMED, SportDiscus and Cochrane. Four studies met the inclusion criteria and were analyzed by two independent reviewers.
Not so surprising, this study only found low evidence that conventional physiotherapy treatment was more effective than education in NSLBP patients. Two out of four studies showed statistical significance when comparing regular physiotherapy to education, but these results were not maintained at long term follow up. One study found education to be significantly more effective than exercise, and the last study showed no difference between the two. Considering these results, the authors propose that treatment of chronic NSLBP should consist of both patient-specific education and advice as well as effective manual therapy and exercise.
> From: Otoo et al., Phys Ther Rev 20 (2016) 16-26. All rights reserved to W.S. Maney & Son Ltd. Click here for the Pubmed summary.