Re: "How Effective is Physical Therapy for Common Low Back Pain Diagnoses?" – SPINE Volume 41, Number 16, pp 1325-1329 2012
September 19, 2016
This article is particularly relevant to the physical therapy profession, considering patients with low back pain make up the largest outpatient population seeking services from physical therapists. The authors' generic use of the term "physical therapy," however, may lead readers to inappropriate conclusions regarding the study's findings.
"Physical therapy" is not a generic term. In essence, physical therapy is a profession made up of physical therapists, physical therapist assistants, and students, analogous to medicine being a profession made up of physicians and medical students. A study on treatments by physicians wouldn't simply report that subjects received "medical care"; it would describe the specific type(s) of treatment(s) provided or be discounted as meaningless.
In the discussion, the authors give potential limitations/weaknesses associated with the study's design. They concede that " … the exact physical therapy provided may not be uniform across the patient population" in this particular study," but that there have been "several randomized controlled trials that have compared the efficacy of various PT modalities for this diagnosis … " The authors further add their intent to "document the real-world effectiveness of PT as currently practiced"; however, in real-world practice physical therapists use their expert knowledge and experience to develop a diagnosis and then a plan of care from an array of services based on the best available evidence for the individual patient.
The article concludes that "… physical therapy for common LBP can be effective for patients; however it would be prudent to consider risk factors for poor outcomes." If readers did not get beyond the article's title and abstract, they may have concluded incorrectly that physical therapy is not effective for a substantial percentage of the population, and therefore not consider physical therapist management as an option.
To promote an accurate representation of the physical therapy profession and facilitate appropriate interpretation of study findings, we suggest and are beginning to advocate for the use of terms such as "physical therapist services," or "physical therapist practice."
Physical therapists provide a wide range of treatments for patients with low back pain depending upon each patient's specific diagnosis. A 2012 study in SPINE1 showed that early access to physical therapy by patients with low back pain improved outcomes and decreased health costs. Another 2012 study in SPINE2 showed that patients receiving early physical therapy for acute low back pain had fewer subsequent surgeries or epidural steroid injections.
Physical therapists are trusted members of the health care team, helping patients with low back pain experience long-term quality of life through achieving freedom of movement and freedom from pain.
Sharon L. Dunn, PT, PhD
American Physical Therapy Association
Board-Certified Clinical Specialist in Orthopaedic Physical Therapy
1Childs J, Fritz J, Flynn T, Wainner, R. Primary care referral of patients with low back pain to physical therapy: impact on future health care utilization and costs. Spine. 2012; 37: 2114-2121.
2Gelhorn AC, Chan L, Martin B, Friedly J. Management patterns in acute low back pain: the role of physical therapy. Spine. 2012; 37: 775-782.