And while we’ve traditionally labeled that as a placebo effect, part of medical treatment is about allowing patients to feel more optimistic because they’re being helped.
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Low back pain afflicts about 70 percent of people in their lifetime and accounts for 2 percent to 5 percent of all doctor visits, according to background notes in the study. Almost half of the participants underwent physical therapy while the other half received the usual care for lower back pain. After three months, early physical therapy showed improvement in disability relative to usual care (P = 0.02). There was no improvement in pain intensity at 4-week, 3-month, or 1-year follow-up (between-group difference, -0.42 [95% CI, -0.90 to 0.02] at 4-week follow-up; -0.38 [95% CI, -0.84 to 0.09] at 3-month follow-up; and -0.17 [95% CI, -0.62 to 0.27] at 1-year follow-up).
Getting into physical therapy right away may help, a study finds, but so will the passage of time.
Current guidelines suggest that physical therapy be held off for a few weeks to see if patients will recover on their own, something these researchers wanted to investigate.
A recent study has found that physical therapy brings in limited benefit in low back pain conditions in comparison to usual care.
“But the difference between the improvement that comes with time and the improvement that comes with therapy is not a huge difference”, she said.
The researchers followed up with the set of patients after a period of one year, and found the patients reported no significant difference between the groups.
Early physical therapy for recent-onset low back pain resulted in statistically significant improvement in disability compared to usual care, but the improvement was modest and did not achieve a difference considered clinically important at the individual patient level.
A very small percentage of people – less than 1 percent, Fritz says – have a serious problem causing their back pain, such as a tumor, fracture or bone infection.
The therapy consisted of back manipulation and exercise.
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And physical therapy won’t be harmful, said Anthony Delitto, professor and chair of physical therapy in the School of Health and Rehabilitation Sciences at the University of Pittsburgh. It also won’t harm the healing the process by teaching people how to stay active. “People were told to go to bed, and that is clearly something they should not do”, Delitto said. These people were randomly assigned to no treatment or physical therapy during the first month after the onset of their pain. “If you’re willing to sit it out, you’re likely to get better without it”, he said. In other cases of sudden low-back pain, patients may be dealing with anything from cancer to kidney stones.
