A 2015 study found that physical therapy provides only modest benefits for lower back pain in older adults.
This study followed more than 200 people with recent-onset lower back pain who were randomly assigned to physical therapy or no treatment for the first month after their pain began. Physical therapy included manipulation and exercise.
The participants that were assigned physical therapy improved their ability to function after three months, compared with the patients who received no physical therapy. However, after a year, no significant difference was found regarding function and there was no improvement in pain after one month, three months or one year of therapy, the researchers said.
The lead researcher, Julie Fritz, a professor of physical therapy at the University of Utah, said that people with lower back pain tend to get better with the help of physical therapy, “But the difference between the improvement that comes with time and the improvement that comes with therapy is not a huge difference,” she said.
The best treatment for lower back pain is to stay active and do exercise even though it may be painful. The goal is to keep people moving to help them recover, and that often happens without assistance.
Around 70 percent of people suffer from back pain in their lifetime, and it accounts for 2 to 5 percent of all doctor visits, according to background notes in the study.
The director of the pain trials center at Brigham and Women’s Hospital in Boston said that chronic back pain is a very complex problem influenced by psychological, social and medical factors.
It makes sense to be as active as possible when new back pain occurs, but physical therapy does not change overall long-term outcomes and does not prevent pain-related disability in the long term.
Current guidelines advise delaying physical therapy for a few weeks to permit recovery, but other authors suggest early physical therapy can be beneficial.
Physical therapy can only slightly accelerate the recovery process. People need to remain active; around 20 years ago, people were told to go to bed, but that is exactly what they should not do.
So, patients should not go to therapy expecting a cure-all. If people are willing to sit it out, they are likely to get better without it.