| You can expect low back pain to trouble 80% of your patient population at some time. With health outcomes and evidence based practice being key issues in healthcare today this short article aims to remind GPs to seek treatment programs that have proven efficacy. The Australian Physiotherapy Association has recently developed a position statement on the efficacy of conservative treatment for low back pain having conducted an extensive literature review with specific reference to physiotherapy treatments.
Research recommends joint mobilisation/manipulation, encouraging early activity, education and specific exercise programs supervised by physiotherapists, as being integral components to an evidence based treatment program.
Evidence based practice treatments should include:
ï Mobilisation/manipulation
ï Early activity
ï Education
ï Specific exercise programs
There is no current evidence to support acupuncture, electrotherapy, traction, bed rest, Feldenkrais, Alexander technique or massage. In the absence of research to justify treatment, the practitioner should provide the referring doctor with treatment goals, a prognosis and details of improvement on examination, and improvement in function to justify further treatment.
Physiotherapists are skilled in manual therapy, patient education and facilitation of specific exercise programs. To improve outcomes look for these evidence based treatment programs when planning management of patients with low back pain.
Ross Baines (MAPA) is a physiotherapist based in Lismore, NSW, Australia.
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