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Medicineworld.org: Physical therapy effective for low-back ache

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Physical therapy effective for low-back ache




A new review article reported in the Journal of the American Academy of Orthopaedic Surgeons should help convince a number of patients with low back pain to consider physical treatment as a first line of therapy for their condition, as per the American Physical Therapy Association (APTA). The review, published in February 2009, recommends that in most cases of symptomatic lumbar degenerative disc disease, a common cause of low back pain (LBP), the most effective therapy is physical treatment combined with anti-inflammatory medications. Approximately 75 to 85 percent of adults will be affected by low back pain during their lifetimes.1.



Physical therapy effective for low-back ache

Symptomatic lumbar degenerative disc disease develops when a disc weakens (often due to repetitive strain), is injured, or deteriorates from aging. As a result, the disc is unable to hold the vertebrae as it should and the lack of stability can cause back pain.

The review details the different therapy methods for symptomatic lumbar degenerative disc disease, including physical treatment with the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and concludes that, in most patients with low back pain, symptoms resolve without surgical intervention. The review also concludes that physical treatment and nonsteroidal anti-inflammatory drugs are the "cornerstones" of non-surgical therapy.

Physical therapist intervention includes strengthening of core muscle groups, including the abdominal wall and lumbar musculature, which can have positive effects in patients with this condition. As per APTA spokesperson Julie Fritz, PT, PhD, ATC, clinical outcomes research scientist at Salt Lake City's Intermountain Healthcare and associate professor at the University of Utah, physical therapists have several therapy options that can help patients with LBP whether due to degenerative disc disease or a variety of other causes.

Exercise and manual treatment including spinal manipulation, have been shown to benefit a number of patients.2, 3. In addition, patient education to remain active and use appropriate body mechanics is beneficial. Physical therapists are trained to identify which of these therapy strategies will be most effective for an individual patient, which further improves the effectiveness of care.

In prior systematic reviews of the literature, it was observed that exercise has been shown to improve function and decrease pain in adult patients with chronic LBP and that physical treatment was beneficial for the therapy of acute LBP.2, 3 In another systematic review, NSAIDs were found to provide LBP patients with short-term symptomatic relief.4.

"Receiving care from a licensed physical therapist can further improve the odds that a patient can maintain their quality of life and avoid surgery," said Fritz. In addition to building the core muscle groups, hands-on treatment to mobilize the spine has been shown to be especially effective. 5, 6 "Spinal manipulation can be an important component of physical therapist therapy for low back pain. Supplementing exercise with spinal manipulation is also beneficial for a number of patients".

Physical therapists can help patients develop a safe and effective exercise program that is tailored to an individual's specific needs and goals. "Surgery should be the last option, but too often patients think of surgery as a cure all and are eager to embark on it," said Luke Madigan, MD, an attending doctor at Knoxville Orthopaedic Clinic, Knoxville, TN, and the main author of the literature review.

Physical therapists are highly-educated, licensed health care professionals who can help patients reduce pain and improve or restore mobility - in a number of cases without expensive surgery or the side effects of prescription medications. APTA represents more than 70,000 physical therapists, physical therapist assistants, and students of physical treatment nationwide. Its purpose is to improve the health and quality of life of individuals through the advancement of physical therapist practice. In most states, patients can make an appointment directly with a physical therapist, without a doctor referral. Learn more about conditions physical therapists can treat and find a physical therapist in your area at www.moveforwardpt.com.

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1Andersson GB: Epidemiological features of chronic low back pain. Lancet 1999; 354:581-585.

2Hayden JA, van Tulder MW, Malmivaara A, Koes BW: Exercise treatment for the therapy of non-specific low back pain. Cochrane Database Syst Rev. 2005;(3):CD000335.

3Assendelft WJ, Morton SC, Yu EI, Suttorp MJ, Shekelle PG: Spinal manipulative treatment for low back pain. Cochrane Database Syst Rev. 2004;(1):CD000447.

4vanTulder MW, Scholten RJ, Koes BW, Deyo RA: Nonsteroidal anti-inflammatory drugs for low back pain: a systematic review within the framework of the Cochrane collaboration back review group Cochrane review. Spine 2000:25:2501-2513.

5Childs JD, Fritz JM, Flynn TW, Irrgang JJ, Johnson KK, Maikowski GR, Delitto A: A clinical prediction rule to identify patients with low back pain most likely to benefit from spinal manipulation: a validation study. Ann Intern Med. 2004; 141(12):920-928.

6Chou R, Huffman LH: Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline.; American Pain Society; American College of Physicians; Ann Intern Med. 2007; 147(7):492-504.

[Last updated: 02/23/09 | Contact: public-relations@apta.org].


Posted by: Mark    Source




Did you know?
A new review article reported in the Journal of the American Academy of Orthopaedic Surgeons should help convince a number of patients with low back pain to consider physical treatment as a first line of therapy for their condition, as per the American Physical Therapy Association (APTA). The review, published in February 2009, recommends that in most cases of symptomatic lumbar degenerative disc disease, a common cause of low back pain (LBP), the most effective therapy is physical treatment combined with anti-inflammatory medications. Approximately 75 to 85 percent of adults will be affected by low back pain during their lifetimes.1.

Medicineworld.org: Physical therapy effective for low-back ache

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