Researchers from the University of Warwick have found that routine physiotherapy for mild to moderate low back pain is no more effective than a single advice session with a physiotherapist.

UK NHS physiotherapists treat around 1.3 million people for low back pain each year, but there is very little evidence for its effectiveness. International guidelines vary but generally recommend advice to remain active.

The study, published in this week's British Medical Journal, involved 286 patients with low back pain of more than six weeks' duration; 144 received therapy and 142 received advice only. Level of disability was measured at two, six, and 12 months.

Patient perceived benefit of treatment was also assessed. Patients in the therapy group were more likely to report benefits from treatment, but there was no evidence of a long term effect of physiotherapy. There were no differences in disability scores or evidence of the long term effect of physiotherapy between the groups of patients who had received physiotherapy and those who had undertaken a single advice session after 12 months.

Routine physiotherapy seems to be no more effective than one session of assessment and advice from a physiotherapist, conclude the authors.

Professor Sarah Stewart Brown, from the University of Warwick, said: "Disability associated with low back pain is a major public health problem in Western societies. There is little evidence for the effectiveness of routine physiotherapy, electrotherapy, laser treatment or traction. However, patients did perceive benefits following physiotherapy.

Previous research suggests that one of the best treatments for back pain is exercise. Exercise programmes that are graded to ensure improvements in cardiovascular or muscular strength are generally more beneficial than physiotherapy. Plus, exercise has a whole range of additional benefits. It can improve in mental health, and can help to reduce obesity and lessen the risk of heart disease."

'Randomised controlled trial of physiotherapy compared with advice for low
back pain' is published in BMJ Volume 329, September 2004

For further information contact: Professor Sarah Stewart-Brown, Warwick Medical School, University of Warwick, Tel: 024 765 74510, Mobile: 07979 070860, Email: sarah.stewart-brown@warwick.ac.uk or Jenny Murray, Press Officer, Communications Office, University of Warwick, Tel: 02476 574 255, Mobile: 07876 21 7710, Email: Jennifer.murray@warwick.ac.uk