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Low Back Pain - What does the evidence say when it comes to treating this common pain?

Published: April 5, 2019

Low Back Pain is the most common musculoskeletal issue we have. In Australia, more than $4.8 billon is spent on managing low back pain. But - what if sufferers were managed better? 

There are some key things when it comes to managing low back pain:

  1. Scans should be avoided unless there is a clear cause, which is only about 2-3% of the time.
  2. Surgery is rarely required.
  3. Most low back pain heals. It is common to have flare ups - and very rarely does it actually represent something that is lifelong.
  4. Poor management - either incorrect treatment, delays in treatment, poor advice from GP's, physio's, chiro's, osteo's, massage therapist's (or neighbours!) or rest is more likely going to lead to chronic issues rather than helping you.
  5. Manual therapy alone (massage, manipulations, needling) is not the best management. Manual therapy is great and certainly has a place, but NEEDS to be combined with appropriate exercise management to achieve a result.

Have a look below at what some of the evidence has to say when it comes to exercise and low back pain.

Study 1: Multidisciplinary bio-psychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis (Kamper, 2015).

  • Multidisciplinary bio-psychosocial rehabilitation involving physiotherapy – exercise based rehabilitation is effective in improving one’s quality of life.

  • Patients are at increased odds of returning to work through this approach compared to just rest and medication.

Study 2: Prevention and treatment of low back pain: evidence, challenges and promising directions (Foster et al., 2018).

  • Exercise, self management strategies and education have been shown to prevent chronic low back pain.

  • The use of opioids, injections and surgery can be avoided with the use of a supervised exercised based rehabilitation program.

Study 3: Non-surgical management of acute & chronic low back pain (Shen et al., 2016).

  • Strong evidence to suggest exercise therapy is an essential component of treatment of patients with low back pain. This will help restore range of movement and strengthening active structures to support the lumbar spine.

Take home message: Physiotherapy management in the form of supervised exercises will reduce pain and improve function in patients with low back pain.