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New Approach To Back Pain Results in Significantly Less Disability Says Study

Timothy Boyer Ph.D.'s picture
Back pain may be treated best with immediate physical therapy.

A new study recommends an approach to back pain that is a change from the initial advice doctors typically give patients.

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Researchers focused on providing evidence-based treatment options for patients with back pain with sciatica that radiates into their leg(s) have a new recommendation that differs from traditional approaches— start physical therapy right away.

A news release from the University Of Utah, cites a study recently published in the Annals of Internal Medicine that following the traditional medical advice for a back-pain patient to remain active and give their symptoms time to subside before considering treatment like physical therapy, might not be the best course of action. The study argues that too often, a wait-and-see approach results in prolonged disability that can last months to years with constant pain.

"As is true for everything with back pain, it's is not the magic bullet for everybody," says Julie Fritz, P.T., Ph.D., associate dean for research in the College of Health, who led the study. "But it seems that physical therapy is something that can be offered to patients to help them regain their activity and recover more quickly."

Researchers at University of Utah Health performed a randomized clinical trial involving 220 patients with back pain and sciatica between the ages of 18 and 60 years old, who on average had been experiencing back pain for 35 days.

According to the news release:

“The study participants were randomly assigned to two treatment groups. Those in the physical therapy group received an active form of physical therapy for four weeks. Physical therapists primarily used exercises and manual techniques such as hands-on spinal mobilization, tailoring the specifics of the treatment to individual patients. Those in the other group received no therapy but were advised to remain active.”

After four weeks the patients were evaluated immediately after, then again at six months and once more a year following treatment. What the researchers found was that the group of patients on a wait-and-see approach of medical care for back pain fared worse when it came to reports about their level of pain and quality of life than did the group that received physical therapy intervention.

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The researchers acknowledge that they cannot pin any specific therapy modality contributing to quicker recovery in the physical therapy group, and report that a few of the participants in both groups did receive steroid injections or undergo surgery to treat their pain. In addition, that differences in provider contact in both groups could also have affected the results to some extent.

However, their conclusion is that their findings merit that seeking a referral from primary care to physical therapy for recent-onset sciatica could benefit patients with improved disability and other outcomes that may not be achieved with traditional “usual-care” treatment.

“Importantly, those differences were large enough to be considered clinically meaningful at the early-outcome time point, suggesting real benefits for patients,” says study co-author Gerard Brennan, P.T., Ph.D., a senior research scientist at Intermountain Healthcare. "This clearly says if you intervene early, these patients can do well," he says.

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Timothy Boyer has a Ph.D. in Molecular and Cellular Biology from the University of Arizona. For 20+ years he has been employed as a freelance health and science writer. Today, with an eye on the latest news, Timothy continues writing about science with a focus on what you need to know for healthier living. For continual updates about health, you can also follow Timothy on Twitter at TimBoyerWrites.

Image Source: Courtesy of Jesper Aggergaard on Unsplash

References:

Back pain with sciatica more likely to improve after early physical therapy” University Of Utah Health News Release 5 OCT. 2020.

Physical Therapy Referral From Primary Care for Acute Back Pain With Sciatica” Julie M. Fritz, PT, PhD. et al, Annals of Internal Medicine 6 Oct. 2020.

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