Which Type of Physical Therapy is Best for Chronic Low Back Pain?
Many people around the world suffer from chronic low back pain (LBP). Researchers are looking for ways to improve this situation. In this study, physical therapists from England compare three types of physical therapy for the management of chronic LBP.

Patients were assigned to either the usual treatment group, the spinal stabilization group, or the pain management group. By comparing the results, the researchers hoped to find out which type of physical therapy worked the best.

The number of physical therapy sessions and length of time with the therapist varied. The usual treatment group received individual treatment, exercises, and instructions in up to 12 sessions lasting 30 minutes each.

The spinal stabilization group was seen for a maximum of eight sessions. Each session was 90 minutes long. And the pain management group received a combination of advice and education along with a general strengthening and fitness program. The therapist also saw this group for eight sessions of 90 minutes length.

Patients were evaluated at six, 12, and 18 months. Measures of outcomes included pain, disability, time off work, and quality of life. In all three groups, the patients were very satisfied with the results of treatment. And the results were similar among the three groups.

There were some differences in costs of treatment. Pain management was less costly than the other two treatments. Individual therapy was the most expensive but had slightly better overall results.

The results of this study suggest that a pain management approach to chronic LBP by physical therapists is both effective and cost-effective. Patients have improved function and use health services less.

The authors suggest that therapists should offer pain management as a first-line method of treatment. Many times, this type of program is tried as a last resort.
Duncan J. Critchley, MSc, et al. Effectiveness and Cost-Effectiveness of Three Types of Physiotherapy Used to Reduce Chronic Low Back Pain Disability. In Spine. June 15, 2007. Vol. 32. No. 14. Pp. 1474-1481.