In patients with low back pain, early physical therapy does not lead to clinically meaningful improvements in disability or pain, a JAMA study finds.
The study included some 200 adults seen in primary care with low back pain of less than 16 days’ duration, with a disability score of 20 or higher (on a 100-point scale), and without symptoms below the knee. Participants were randomized to usual care (educational materials and advice to remain active) either alone or with four PT sessions (spinal manipulation and exercise) over 3 weeks.
At 3 months, the mean disability score was statistically significantly better in the PT group than in the usual-care group, but the between-groups difference (3 points) was not clinically meaningful. In addition, the groups generally didn’t differ in pain or quality-of-life scores or in healthcare utilization.
Dr. Thomas Schwenk, deputy editor of NEJM Journal Watch General Medicine, said: “Overall, these results support guidelines that conclude there is no value for early PT” in patients with low back pain.
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