The days of using ultrasound and hot packs for low back pain are long gone (or at least they should be!).  Extensive research has been conducted in many areas of physiotherapy, with low back pain being one of the areas most studied.  Over the years we have spent a great deal of time and money to determine which treatment techniques are most likely to be effective in treating low back pain.  So why do so many physiotherapists ignore this research?

Low back pain is the most common cause of disability and the most frequent reason for time missed at work.  A recent study by Delitto et al. in JOSPT (April 2012) sought out the best practice guidelines for grouping people with low back pain, then using the most effective techniques proven to help people within those groups.

The study found that manual therapy techniques such as manipulation is effective for acute low back pain, subacute, and chronic back pain with movement impairments. In other groups of patients, techniques such as nerve mobilization, strength and stability exercise, or endurance exercises are the most effective treatment strategies.  None of the literature supports treatments such as bed rest, ultrasound, or hot packs as the primary treatment strategy.

These types of studies are helpful to decide which technique is most likely to be helpful for a client. The problem is that many therapists do not have sufficient training to perform manipulation techniques, or advise people on which exercises they should be doing for instance. It is also important to remember that no two clients are identical in presentation, so a skilled physiotherapist is able to accurately assess their patient and determine the best course of action, using their own skill and knowledge as well as the scientific evidence.

At South Simcoe Physiotherapy, our therapists are skilled in assessment techniques, manual therapy, and exercise prescription.  We are constantly learning to ensure that our clients get the most effective treatment techniques so that they can get better faster!

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