By Amy Orciari Herman
Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD
NEJM Journal Watch
Patients with acute low back pain and sciatica who are referred early to physical therapy see improved outcomes at 6 months, according to a randomized trial in the Annals of Internal Medicine.
Some 200 adults who presented to primary care with low back pain and sciatica that had lasted no more than 90 days received education about low back pain either alone (usual care) or with a referral to start physical therapy within 3 days. Physical therapy included six to eight sessions over 4 weeks, plus home exercises.
The primary outcome — the change in patient-reported disability at 6 months — significantly favored physical therapy over usual care (mean reduction: 22.4 points vs. 17.0 points on a 100-point scale). The difference between groups persisted at 1 year. Several secondary outcomes, including self-rated back pain, also favored physical therapy.
Editorialists call the observed effects of physical therapy “average, modest, but nevertheless, beneficial.”