Physical Therapists Stimulate Thinking about Treatments for Low Back Pain

Physical therapists use many methods of treating patients with acute (sudden or recent) low back pain. Two of these methods are manipulative therapy (MT) and interferential therapy (IFT). MT involves manipulating the spine. IFT is a form of electrical stimulation. These treatments are popular for the management of low back pain, but they haven't been proven effective.

In this study, therapists from Ireland report on the use of MT and IFT. They used just one of the treatments on some patients. The therapists combined the two treatments for other patients. All patients were seen from four to 10 times during an eight-week period.

The patients kept up with their normal activities during treatment. Everyone received a book on back care to help them learn about back pain and its treatment. Results of treatment were measured using pain levels, quality of life, number of days missed at work, and use of pain relievers. Measures were taken before treatment, when treatment ended, and six and 12 months later.

Here are the main findings. Everyone got better and stayed that way for up to 12 months. It didn't matter whether they had MT, IFT, or both together. Patients' general health was unchanged as a result of treatment, but 70 percent had another episode of back pain later.

This is the first study to report on the use of MT and IFT in the treatment of acute back pain. The results may challenge physical therapists who use either of these treatments alone or together for low back pain. Using MT and IFT together adds more cost without proof that either one works.

Deidre A. Hurley, BSc (Hons), MAppSc (Manip Ther), PhD, MISCP, MCSP, et al. A Randomized Clinical Trial of Manipulative Therapy and Interferential Therapy for Acute Low Back Pain. In Spine. October 15,2004. Vol. 29. No. 20. Pp. 2207-2216.

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