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DIY cure for back pain
Advice about exercise, fitness, and mental attitude beats back pain as effectively as physiotherapy sessions, a study has shown.
Doctors' guidelines encourage referral to a physiotherapist for non-specific back pain when medication and simple self-management messages have not worked.
Research published in The Lancet medical journal today showed that it is not necessary for the therapist to apply physical treatment in a clinic.
An exercise and education programme worked out for the patient was just as effective.
Professor Elaine Hay, from the University of Keele, Staffordshire, compared the two approaches in the treatment of low back pain lasting less than 12 weeks.
Psychosocial barriers
The pain management programme included general fitness and exercise advice, and educational strategies to overcome the psychosocial barriers to recovery.
A total of 400 adults from 28 general practices in the UK were recruited for the research.
Clinical outcomes were the same for patients given the pain management programme, and sessions of physiotherapy.
Professor Hay said: "Our findings provide a choice of approach for physiotherapists and suggest that manual therapy is not essential as an initial treatment for patients with sub-acute low back pain.
"The pain management package was delivered in fewer treatment sessions, resulted in fewer referrals to secondary care than the traditional approach, and might be an efficient first-line approach to care of patients with low back pain presenting in primary care practice."
"One-size-fits-all" approach'
Graham Pope, from the Chartered Society of Physiotherapy, said: "This study provides firm evidence that physiotherapy is an effective treatment for low back pain.
"It suggests that a 'one-size-fits-all' approach cannot be applied to back problems and that physiotherapists have the skills and expertise to determine and deliver the most appropriate course of action for patients.
"It should be noted that the alternative to manual therapy offered to patients in this study was not simply advice; it was a complex pain management programme.
"This includes instruction on suitable exercises, education to reduce fear and anxiety arising from back pain and the development of coping strategies to encourage patients to return to normal activities."
