Study Of Back Pain Therapies

More than 80 percent of the mankind has been a victim of backache at some point or another other in their lives. Being self limiting, this condition, in most cases, automatically vanishes in a couple of months.

Yet, there is still a debate on which technique works the best for resolution of a chronic backache. Many treatments in combination are prescribed to patients in such cases; some of these include physiotherapy, massage, exercise therapy, ultrasound, heat traction or short wave diathermy.

A Review
A review was conducted by the famed Bouter LM, Knipschild, Beckerman H and Koes BW towards backache and physiotherapy. They concluded their research in 1990, wherein they did 16 trials and observed an improvement in pain and mobility.

Findings
Most of these trials were poor in quality, with poorly designed methodology, inadequate designs for assessment of intervention. A range of nature of interventions, like the control and length was used between trials. Out of the sixteen trials, only six trials concluded positively.

Inactive comparisons
Out of the sixteen trials, four were chosen to compare and contrast therapies which included exercises against those that did not include exercise. Resultantly, one of these trials reported a positive result, but that too not for three months. The rest of them were the same, with no gain in acute pain, chronic low pack pain or even sciatic symptoms.

Active Comparisons
Exercise therapy was performed in comparison with the traditional conservative mode of treatment. Out of them, two trials benefited from modes of treatment like a session of mini-back school combined with some rest and hot packs. The rest of the trials did not show any improvement.

Comparison of different exercise therapies
There was a range of eight trials which carried out comparison between different modes of exercise. This mainly concentrated on extension exercises compared with isometric flexion exercises. Out of these, 4 trials didn’t not show and significant improvement. The rest demonstrated slight improvement.

The ones where intensive dynamic back extensor exercises were performed for three months showed little benefit and he rest benefited from extension exercises rather than flexion exercises and lastly, two preferred flexion over mobilization in combination with trials, heat and massages.

The Bottom line
Trials alone cannot guarantee complete qualitative inference. We cannot conclude if physiotherapy should be preferred over other conservational line of treatments. It still is unclear whether which line of treatment should be recommended for back aches.