Consumer Reports: Physical Therapy Among Top Treatments for Back Pain

"Hands-On" Therapies Rated More Effective Than Traditional Medical Care 

ALEXANDRIA, VA, April 9, 2009 - Physical therapy ranks among the top treatment choices of their readers with back pain, according to a new Consumer Reports survey of more than 14,000 Americans who experience the condition. In the survey, physical therapist treatment and other "hands on" therapies outranked treatment by medical specialists and primary care providers, a result that should prompt more patients to seek conservative options as a first line of treatment for their back pain, according to the American Physical Therapy Association (APTA) and its Orthopaedic Section. The article also urges caution when using prescription narcotics for back pain.

"Physical therapists, who are experts at improving mobility and restoring motion in people's lives, can successfully provide very effective, safe and comprehensive treatment for back pain in many instances," said APTA President R. Scott Ward, PT, PhD. "In today's challenging economic times, it is important for consumers to know that physical therapist intervention can also be a more affordable and cost effective option."

A growing body of evidence is pointing toward the effectiveness of physical therapist treatment for low back pain. A review article published in the February 2009 Journal of the American Academy of Orthopaedic Surgeons1 recommended that in most cases of symptomatic lumbar degenerative disc disease, a common cause of low back pain (LBP), the most effective treatment is physical therapy combined with anti-inflammatory medications.

"For pain of a 'mechanical' origin such as low back pain, hands-on physical therapy to mobilize the spine and exercises designed to alleviate low back pain have been shown to be particularly effective and have long-lasting effects on patients," said James J. Irrgang, PT, PhD, ATC, president of the APTA Orthopaedic Section. "In addition to being able to provide manual therapy treatments, physical therapists are best known for providing exercises to restore mobility and prevent recurrence of low back injuries."

Additionally, a systematic review published in the January issue of Physical Therapy (PTJ)2, APTA's scientific journal, found that motor control exercises, a new form of exercise for back pain that has gained the attention of researchers and health practitioners over the past decade, can significantly reduce pain and disability when performed in conjunction with other forms of therapy, in patients with persistent low back pain.

In addition to pointing out the benefits of manual therapy, the Consumer Reports article also urges back pain sufferers to be judicious in their use of prescription medications. According to Orly Avitzur, MD, a board certified neurologist and medical advisor to Consumers Union, who comments in the Consumer Reportspiece, half of the respondents to the low-back-pain survey who were prescribed drugs for their pain received an opioid pain reliever in spite of the fact that there is little evidence to support their use in treatment of lower back pain. And, clinical trials have shown, says Avitzur, that 50 percent of those who take them experience unpleasant side effects, including cramping, vomiting and nausea to name a few.

Avitzur mentions that 25 percent of users of opioid pain relievers suffer substance-use disorders like overuse. She goes on to say that "prescriptions of opioids among patients with spinal disorders more than doubled from 1997 to 2004" and reports of opioid overdose have risen with the numbers of prescriptions.

"So many people are more conscious of what they eat and drink than of the medications they often use without a second thought," said Ward. "Instead of opening up the medicine cabinet as the first instinct, patients should first consider physical therapy as a less-invasive, safer and more cost-effective approach."

In most states patients can now go directly to their physical therapist for treatment without the need for a referral from a physician. Physical therapists can diagnose and then design an appropriate treatment plan. Visit www.moveforwardpt.com to find a physical therapist near you.

Click here to read the Consumer Reports article.

Physical therapists are highly-educated, licensed health care professionals who can help patients reduce pain and improve or restore mobility – in many 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 therapy 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 physician referral. Learn more about conditions physical therapists can treat and find a physical therapist in your area at www.moveforwardpt.com 


1 Madigan L, Vaccaro, A, Spector, L, Milam RA, MD. Management of symptomatic lumbar degenerative disk disease. J Am Acad Orthop Surg. 2009; 17:102-111. 

2 Macedo L, Maher C, Latimer J,  McAuley J. Motor control exercise for persistent, nonspecific low back pain: A systematic review, Phys Ther. 2009; 89: 9-25. 

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