06.1 What Treatments Work for Chronic Low Back Pain

Recommendations based on current available evidence helps you combine your personal experience and expectations with research to form an individual treatment plan and find treatments with the most promising results.

What treatment should I consider for my back pain?

There are many guidelines regarding LBP and some even especially for chronic LBP.

In this episode you will find information about the treatment options often recommended in these guidelines.

Setting evidence into your personal situation

After having examined all the best available evidence from systematic research it is important to know how to apply this information to your individual situation.

Evidenced based treatment is more than simply the best available evidence from systematic research alone.

It should also take into account the expertise of your clinician(s) as well as your personal expectations, beliefs and preferences!1,2,3

Treatment Recommendations with strong supporting evidence

• Information, education and self-care

"All the guidelines explicitly underline the importance of educating and providing patients with information on LBP with regard to their expected course and the possibility of effective prevention and selfcare options."4

• Physical activity and therapeutic exercise

"There is strong evidence that physical activity and therapeutic exercise are effective for the management of CLBP, even if it is not clear what kind of exercise is best. An individual, graded and active exercise program supervised by an expert (physical therapist) is almost always recommended."4

• Multidisciplinary treatment programs

"Combined physical and psychological interventions with cognitive-behavioral therapy and exercise are particularly recommended for people who have received at least one course of less intensive treatment and have high disability and/or significant psychological distress."4

All other forms of treatment are currently categorized using the following descriptions:

Might do - recommendations with moderate supporting evidence

Don't know - recommendations with limited or inconclusive evidence

Don't do - recommendations with strong evidence against intervention

For more information of other treatment options please refer to the original article which can be found via the Internet: "An updated overview of clinical guidelines for chronic low back pain management in primary care."4

Find out more: www.mybackrecovery.com

Literature:

1. Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. 1996. Clin Orthop Relat Res. 2007;455:3–5. Available at: http://www.ncbi.nlm.nih.gov/pubmed/17340682. Accessed December 16, 2012.
2. Manske RC, Lehecka BJ. Evidence - based medicine/practice in sports physical therapy. Int J Sports Phys Ther. 2012;7(5):461–73. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3474298&tool=pmcentrez&rendertype=abstract. Accessed December 16, 2012.
3. Jette DU, Bacon K, Batty C, et al. Evidence-based practice: beliefs, attitudes, knowledge, and behaviors of physical therapists. Phys Ther. 2003;83(9):786–805. Available at: http://www.ncbi.nlm.nih.gov/pubmed/12940766. Accessed October 5, 2012.
4. Pillastrini P, Gardenghi I, Bonetti F, et al. An updated overview of clinical guidelines for chronic low back pain management in primary care. Jt Bone Spine. 2012;79(2):176–185. doi:10.1016/j.jbspin.2011.03.019.