Research Articles – Back


January 2019

Comprehensive conservative intervention improves walking ability
in lumbar spinal stenosis patients

Lumbar spinal stenosis is a condition in which the canal that surrounds the spinal cord begins to narrow, which puts pressure on the nerves that travel to the lower back and legs. It is a leading cause of pain and disability in older adults, and is going to become even more common as the population continues to age. Most patients with lumbar spinal stenosis undergo non-surgical treatments rather than surgery, but there is a lack of research on the effectiveness of this approach. Therefore, a powerful study was conducted, and results showed that patients who completed a non-surgical treatment program experienced notable improvements in pain, disability, and their ability to walk, which is one of the primary impairments associated with lumbar spinal stenosis.

Immediately going to a physical therapist for back pain
found to reduce patients’ costs and use of healthcare

Low back pain is the leading cause of disability in the world, and about 20% of patients with this condition are referred to a physical therapist by their doctor. Although it is generally agreed that these patients should remain active when low back pain strikes, there is no consensus on when the best time is to begin physical therapy. Some experts recommend starting right away while others suggest delaying it, and there is not a great deal of research on the potential benefits of immediate physical therapy. With this in mind, researchers conducted a study to examine healthcare usage and costs when patients receive physical therapy at various points in time. Results showed that patients who received treatment immediately reported the lowest healthcare usage and costs in nearly all outcomes measured, and the longer they waited, the more healthcare they used.

December 2018

Direct access of physical therapy leads
to lower costs for neck pain patients

Neck and back pain are two of the most common conditions that lead to disability, and although healthcare costs are continuing to increase, patient outcomes are not improving. This may be partially due to the fact that many patients are given treatments that provide little to no effect on their condition, and their access to care is often poor or delayed. What many patients may not realize is that direct access allows them to see a physical therapist without a doctor’s referral, and undergoing therapy in this manner has been associated with fewer days of care and lower costs. Noting that more research was needed on the costs associated with direct access to physical therapy, a study was conducted. The results showed that regardless of whether patients accessed physical therapy directly or through a referral, most improved in pain and disability, and there were no significant differences between the two groups. Direct access patients also had significantly fewer treatment sessions and days in care, and spent an average of $1,543 less than those who accessed care in the traditional manner.

In a real-world setting, physical therapy is
effective for about half of neck pain patients

mericans report having experienced it within the past three months. Physical therapy is one of the many treatment options available for neck pain, and many studies have shown that it’s efficacious for these patients, meaning it leads to improvements in a very carefully controlled population. However, there is very little research on the real-world effectiveness of physical therapy in a random sample of individuals with neck pain. For this reason, a study was conducted, and the results indicated that physical therapy had a real-world effectiveness of approximately 50%, and worker’s compensation status was found to be associated with an increased chance of failing treatment.

Seeing a physical therapist early for neck pain is associated
with lower costs and less use of healthcare

Neck pain is one of the most common reasons individuals seek out treatment, and most go to their primary care doctor for an evaluation. Doctors usually recommend medication, additional testing, or a referral to a specialist, but evidence is lacking to support many of the approaches that are typically used. On the other hand, recently published guidelines recommend physical therapy for neck pain because it’s been found to reduce patients’ costs and their use of healthcare. Patients are also advised to see a physical therapist as soon as possible, but there is little research to evaluate how the timing of therapy affects costs, so a study was conducted. Results showed that patients who saw a physical therapist early typically underwent fewer treatments and tests, and spent less on their care compared to those who waited more than 90 days in some cases. Patients who went to a physical therapist early also spent an average of $2,172 less on healthcare than those who waited, in part because they were less likely undergo have additional tests and procedures after starting therapy.

Exercise found to reduce the risk of experiencing a new episode of neck pain

Neck pain ranks as the fourth leading cause of disability in the world, and about 48.5% of the population will experience it at some point in their lives. Individuals with neck pain generally improve over time, but in many cases the pain comes back and can eventually become a long-term problem. This shows why it’s important to prevent neck pain from developing in the first place, but current guidelines don’t include any specific recommendations for prevention. Therefore, a powerful pair of studies was conducted to determine which strategies are most effective for preventing an initial episode of neck pain in individuals without symptoms. Researchers found moderate-quality evidence that showed exercise substantially reduced the risk of a new episode of neck pain by about 50%. They also found that ergonomic programs, which instruct patients to make modifications to their workstations and homes to improve their posture, do not reduce the risk of a new episode of neck pain. Individuals who work a desk job that are concerned with their risk for neck pain are therefore encouraged to see a physical therapist for a preventative exercise program.

Adding a hands-on treatment to a physical therapy program
leads to even better results for patients with neck pain

Neck pain is one of the most common health problems in the world, as up to 71% of the population will experience it at least once. While most people improve within a few weeks, some go on to develop chronic neck pain, which is essentially a long-term form of the condition that does not respond to normal treatments. This shows why it’s important to treat neck pain early and avoid long-term complications. Physical therapy is commonly used to address chronic neck pain patients and it often includes manual therapy, in which the physical therapist mobilizes to the neck muscles to alleviate pain. But despite the popularity of manual therapy, evidence is lacking to support its effectiveness, which led to researchers to conduct a study on the topic.

Results: physical therapy in general was effective for helping patients with chronic neck pain improve, but adding manual therapy led to even better overall outcomes for patients.

Neck stretching and strengthening exercises guided by a physical therapist
lead to less neck pain and related anxiety in patients

Neck pain is currently the fourth leading cause of disability in the U.S., and its prevalence is also high throughout the rest of the world. Unfortunately, many individuals with chronic neck pain—meaning it has lasted for more than three months—deal with symptoms of anxiety and depression in addition to their physical symptoms. For this reason, it’s important to develop treatments that are found to improve patients’ emotional wellbeing as well as their physical issues. One possible way to accomplish this is through a physical therapy program that involves a variety of exercises for the neck and surrounding muscles. Therefore, a study was conducted to evaluate whether a series of neck exercises and a home-exercise program was effective for reducing neck pain and anxiety and/or depression levels.

Results: combining physical therapist-led exercises that targeted certain neck muscles and a home-based exercise program reduced patients’ chronic neck pain while also alleviating some of their anxiety and depression related to this pain.

Patients who receive opioids before neck surgery
take longer to return to work than those who do not

When non-surgical methods like physical therapy fail to bring about improvements in patients with neck pain, surgery may be recommended to address their issue. For people receiving workers’ compensation, surgery can pose a serious problem, since it means more time away from work without a guarantee of a successful recovery. The use of opioids can complicate this issue even more, since these individuals already have worse surgery outcomes and because opioids are associated with extended disability and higher costs. It is therefore important to determine if opioid usage before neck surgery has any impact on the amount of time needed to return to work, and a study was conducted to investigate just this.

Results: using opioids before neck surgery had a negative effect on returning to work, days absent from work afterwards and several other factors.

Exercises that strengthen the neck and shoulders
are found to reduce neck pain in office workers

Studies have suggested that up to 63% of office workers are affected by neck pain, and between 34-49% of these workers report a new episode of neck pain each year. This poses a serious problem in the workplace, as those who are unable to return to work within a few months are at a high risk for developing disability and possibly being incapable of working in the long term. It is therefore important to develop interventions to alleviate office workers’ neck pain and reduce the burden of this condition on the workplace. For this reason, a powerful pair of studies was conducted to determine if any workplace interventions are actually capable of reducing neck pain in office workers. Results were generally supportive of workplace-based interventions, and the programs that included strengthening exercises for the neck and shoulder muscles were most effective in the office workers who had neck pain. In addition, it was found that the longer these office workers participated in the exercise intervention, the greater the reduction in their neck pain. Business owners and policymakers should therefore consider incorporating one of these types of programs into their workplace to address the growing problem of neck pain in that environment.

Spine strengthening exercise and posture training
reduces hyperkyphosis in older adults

Kyphosis is a disorder in which an excessive outward curvature of the spine results in an abnormal rounding of the upper back. Kyphosis generally tends to get worse with age, and once the angle progresses past 40°, it’s referred to as hyperkyphosis. Research has shown that strengthening exercises for the back muscles can lead to improvements in patients with hyperkyphosis, but most studies on the topic suffered from some limitations. For this reason, a powerful study called a randomized-controlled trial was conducted. Results showed that patients who followed the physical therapist-led exercise program experienced several significant improvements when compared to patients who only received education. Most importantly, the angle of the curvature of the spine reduced by an average of 3.3° in the treatment group, compared to only 0.3° in the other group. The treatment group also reported better self-image and satisfaction with their appearance after completing treatment. These findings suggest that a treatment program consisting of strengthening exercises for the spine and posture training can lead to physical improvements in patients with hyperkyphosis, which appear to boost their confidence.

Patients treated early for neck and back pain in the emergency room
experience better outcomes than those who wait

Many emergency departments have a finite number of resources available, which forces them to prioritize the treatment of patients based on their condition. Injuries like neck and back pain account for a significant portion of the conditions seen in emergency rooms, and having an overflow of these patients can create a long wait list. Patients who fall into this category may either be treated or discharged from the hospital, and some will be referred to physical therapy for additional treatment. Unfortunately, many patients do not receive appropriate care quickly enough due to the overflow and other reasons, but one way to improve this system is to treat these patients with physical therapy as early as possible. To evaluate this type of approach, a study was conducted, and results showed that participants treated with early physical therapy had significantly lower levels of pain and disability compared to those treated with standard care. The median value of pain was 1 and 9% of patients reported disability in the early physical therapy group, while the other group reported a score of 4 for pain and 33.4% were disabled. Patients treated with early physical therapy also reported greater satisfaction with their treatment and had fewer prescriptions for pain-relieving medications than the others group. These findings show that staffing an emergency room with a physical therapist can help patients with neck or back pain recover more quickly, while also freeing up other emergency room doctors to treat other patients.

Most guidelines recommend education, physical therapy
and exercise for low back pain

Low back pain is one of the most common of all sources of disability, as more than 80% of people will experience it at least once in their lives. There are many treatments available for LBP, and it may be difficult for some doctors to determine which is the best possible approach for each patient. For this reason, a number of guidelines have been developed that are intended to simplify this process. The only possible downside is that the quality of some of these guidelines is not very high and can lead to recommendations for treatments that are not effective or even harmful. Researchers therefore decided to conduct a review of all the guidelines available for treating low back pain, and the results identified several treatments that were universally supported by all guidelines reviewed. Some of the strongest recommendations included advice and/or education, returning to activities or staying active, and a hands-on form of physical therapy called spinal manipulation. All of these interventions are fundamental components of most physical therapy programs, and individuals with low back pain are therefore urged to see a physical therapist if they are dealing with symptoms to receive the best possible care available.

Patients who have higher levels of low back pain
get the most benefits from physical therapy

Low back pain is one of the most common painful conditions in existence, as up to 36% of the population will experience it at least once each year. Physical therapy is frequently used to treat low back pain, but it’s been found to be more effective in some patients than others. For this reason, one of the main goals of researchers is to identify specific groups of patients that respond to treatment best, which can help medical professionals make better treatment decisions. Therefore, a study was conducted that compared the effects of physical therapy to advice with the goal of determining which patients had the best responses to treatment. Results showed that patients who had higher levels of pain, a higher risk for persistent pain, a longer duration of symptoms and less of an ability to cope with their condition experienced the greatest benefits from physical therapy compared to advice. On the opposite end, results showed that patients who had low back pain that was not very severe responded well to advice alone. Based on these findings, it seems that patients who have the most intense cases of low back pain stand to benefit the most from an individualized physical therapy treatment program.

Neck pain has a notable effect on the
lives of women who work in an office

Neck pain is very prevalent in general, but it is especially common in working individuals, where it occurs in 45-63% of the population worldwide. Although so many people deal with this condition in the workplace, it’s not clearly known how their pain impacts work performance and which strategies are most effective for treating it. For this reason, a study was conducted to describe the consequences of neck pain on female office workers and explore what strategies are used to manage and cope with the condition. Results showed that out of the 51 female office workers who participated, 82% experienced neck pain in the last 12 months. About 20.7% of participants with neck pain missed work on account of their pain, and 22.4% reduced their work activity because of it. The most common strategies for managing neck pain were prescription or over-the-counter medications (82.5%), physical therapy (64.7%) and visiting their general medical professional (54.9%). These results show that neck pain can certainly impact work performance if they fail to seek out effective treatments like physical therapy to address it.

A physical therapy program following back surgery
significantly helps with recovery

Low back pain is the single leading cause of disability throughout the world, and about 31 million Americans experience it at any given point in time. There are many different conditions that may lead to the development of low back pain, and one of the most common is called degenerative disc disease. Non-surgical treatments like physical therapy are typically recommended for this condition at first, but surgery may be considered if a patient doesn’t improve or gets worse. After surgery, physical therapy is often prescribed to help patients recover properly, but there is a general lack of research that investigates the effects of this type of treatment. For this reason, a study was conducted to evaluate the long-term effectiveness of physical therapy following a surgery. Results showed that patients who received four or more sessions of physical therapy following surgery experienced to the most significant improvements out of three study groups. In particular, these participants showed less disability, reduced pain and better quality of life than the other two groups, and these improvements lasted for 24 months. These findings suggest that at least four sessions of physical therapy after surgery can lead to various improvements for patients that are maintained in the long term.

Vast majority of individuals with no symptoms
have signs of bulging disc in neck

Magnetic resonance imaging (MRI) scans are commonly used to capture images of the spine and diagnose many disorders in the region that cannot be detected any other way. Medical professionals like surgeons use these MRIs to make decisions about the most appropriate treatment to prescribe, and sometimes to determine if a patient needs surgery or not. Unfortunately, some doctors suggest surgery even if abnormal MRI findings are the only reason for their decision. Instead, they should only be making this call if other symptoms like back pain are also present in the patient. To develop a clearer understanding of just how many people have abnormal MRI findings of the neck, a study was conducted of individuals with no signs of neck pain. Results showed that of the 1,211 volunteers without any symptoms of neck problems, the vast majority (87.6%) had significant disc bulging on their MRIs. Since bulging discs are so common, medical professionals should only evaluate the findings of patients’ MRIs along with the actual symptoms they are experiencing. Patients should also be aware that having a bulging disc – or discs – is usually quite normal and should not be a matter of concern until other symptoms arise.

Combining education with physical activity and specific exercises
is beneficial for patients with long-term neck pain

Neck pain is a major problem that affects an estimated 30-50% of the population each year. Although most cases of neck pain improve on their own within a reasonable amount of time, for some individuals it becomes a long-term problem, which is called chronic neck pain. There are many treatments available for chronic neck pain, and education and specific exercises for the neck are considered beneficial interventions, but there is a lack of information that evaluates the two treatments being used together. A powerful study called a randomized-controlled trial was therefore conducted, and results showed that patients who received both education and exercises had better muscle function, neck flexibility and pain threshold, as well as improved mood and both mental and physical quality of life.

Seeing a physical therapist early for neck pain is better than waiting

Under the current system, most health care in the U.S. is delivered in a model that allows doctors to receive payment regardless of whether patient improve. It’s one of the main reasons healthcare costs are so high, and is part of the problem that needs to be fixed.
One possible solution to reduce costs is to recommend early physical therapy for disorders like neck pain, the second most common painful condition behind low back pain. Doing so may save patients money, but it has not been well researched, which prompted a new study. The results showed that patients who received early physical therapy experienced better outcomes with less disability and pain than those who delayed it. This was found to be the case not only in their actual outcomes, but in their value as well, since patients got more out of each dollar they spent with early physical therapy over delayed physical therapy. This topic requires more research, but patients with neck pain are encouraged to seek out physical therapy early rather than waiting in order to receive the greatest possible benefits while saving money.

Patients who see physical therapists that follow guidelines
spend less time and money on treatment

Approximately 84% of the population will go on to experience at least one episode of low back pain at some point in their lifetime. Most of these cases will improve completely in 2-4 weeks, but about 25% of individuals have to deal with long-term pain and other problems. Physical therapists are one of the many different types of medical professionals that treat patients with long-term—or chronic—low back pain, and they are all supposed to follow a set of guidelines in order to provide the best possible care. Unfortunately, only about 30% of physical therapists actually follow these guidelines, and this may have an effect on the outcomes patients experience and how much they spend on treatment. To develop a clearer understanding of how following these guidelines can impact the care patients receive, a powerful study called a systematic review was conducted. The findings showed that when physical therapists gave treatment in line with guidelines, patients needed fewer visits to improve and spent less overall than those who did not. Patients with low back pain should therefore check to see if their physical therapist is following the current clinical practice guidelines for low back pain before making any treatment decisions.

Properly examining the neck can lead to a
more accurate diagnosis of headaches

Headaches are extremely common, as about 96% of people will experience at least one of them in their lifetime. Cervicogenic headaches are one type of headache that results from a dysfunction of the neck region of the spine, and they account for about 15-20% of all headaches. One problem with a cervicogenic headache is that many of their signs and symptoms overlap with other types of headaches, and it’s difficult to properly diagnose them. For this reason, a powerful study called a systematic review was performed to determine the best physical examination to diagnose cervicogenic headaches. Results showed that the cervical flexion-rotation test was most accurate. This is a test performed by a physical therapist that has patients flex and rotate their neck to see how it moves. By using this test, physical therapists can more accurately diagnose these types of headaches and give patients the proper treatment they need.

Athletes who have surgery return to sports
at about the same rate as those treated without surgery

Low back pain is a common issue for many competitive athletes that can cause long-term complications if it’s not treated properly. Although there are many causes of low back pain, a condition called herniated disc is often responsible in the athletic population. When it comes to treating herniated discs, it’s not clear whether using surgery or non-surgical methods are more effective, even though surgery was once considered the norm. For this reason, a powerful pair of studies called a systematic review and meta-analysis was conducted on the topic. The meta-analysis assessed 14 studies with data on both professional and amateur athletes, and results showed that there were no significant differences between athletes treated with surgery and those treated with other approaches. While some athletes returned to their sport quicker after having surgery, others returned quicker following other treatments, and the rates were quite similar. Based on this finding, athletes with a herniated disc should utilize non-surgical treatments like physical therapy first before considering surgery, which is more expensive and carries a greater risk for complications.

Surgery and physical therapy lead to very
similar results for patients with back condition

Lumbar spinal stenosis (LSS) is a common condition in which the space that surrounds the spinal cord narrows, which can cause pain and weakness in the lower back, buttocks and thighs. Treatment for LSS may be either surgical or conservative (non-surgical), which often includes physical therapy and exercise. Although surgery and physical therapy have been compared in studies before, it’s still not clear which is superior for treating LSS. For this reason, a powerful study called a randomized-controlled trial was conducted that directly compared these two types of treatment for LSS patients. At the end of the study, there were no major differences between patients that had surgery or physical therapy in regards to relieving their symptoms and improving their function, and this was found to be the case for up to two years. Surgery also led to many more complications that physical therapy. This study points out that both treatments lead to very similar results, but surgery is much more costly and causes more complications than physical therapy. Therefore, patients with LSS should carefully weigh their options when deciding which treatment is best for them.

Specific exercises are better than general
physical activity for patients with whiplash

Whiplash is a neck injury that occurs from a forceful, back-and-forth movement of the neck. It often leads to pain and stiffness that can last for a while, and about 50% of patients that have a whiplash injury experience symptoms for more than one year. When it comes to treating these patients, many are told to remain physically active and perform general exercises for their pain, even though research has shown that specific exercises for the neck are more effective. Since this topic has not been investigated in much detail, a study was conducted that compared multiple different approaches for patients with whiplash symptoms. Results showed that neck-specific exercises helped patients improve more than general physical activity, as previous studies have already shown. For this reason, patients dealing with symptoms from a whiplash injury should be treated with these types of exercises from a physical therapist rather than being told to keep to a general exercise regimen.

Adding specific training exercises to
education makes it more effective for neck pain

Neck pain is a common disorder that affects about 37% of the population. In some cases, patients deal with pain that does not improve after three months, at which point it’s labeled chronic neck pain. Studies have shown that both exercise training for neck muscles and education are effective for chronic neck pain, but it’s not clear how they work when used together. Therefore, a powerful study called a randomized-controlled trial was conducted to compare the effects of both treatments for chronic neck patients. Results showed that the combination of exercise and education was more effective than exercise alone, as patients in this group experienced improved balance and less pain. This suggests that education should be incorporated into any treatment program for neck pain, but it needs to be combined with exercise in order to lead to significant improvements.

A combination of therapy, exercise and
education is best for neck pain

Chronic neck pain is a common condition in which patients deal with high levels of disability and pain for more than 12 weeks. Some people may also experience psychological issues like depression and anxiety. Though exercise prescribed by a physical therapist is usually effective for this type of neck pain, education may also be needed to help address the psychological issues that patients might be experiencing. To determine just how effective combining exercise and education is, a study was conducted in which patients were treated with education, exercise or both. Results showed that patients in all groups improved, but those who received exercise and education experienced greater improvements overall. This highlights the importance of educating patients in any treatment program for low back pain.

The type of medical professional you see for
low back pain may affect recommendations

Low back pain is an issue most people will face at some point in their lives, and when it occurs, each person has a choice of who will treat them. The decision of what type of medical professional to visit first is important and can affect the prognosis, treatments and their costs. To determine just how much this choice can affect the type of care given for low back pain, a study on the topic was conducted. Results showed that when compared to seeing a primary care doctor first, seeing a physiatrist was associated with higher costs and a higher likelihood of having additional tests, injections and surgery. (A physiatrist is a doctor who handles similar conditions to physical therapists, but they only prescribe therapies rather than perform them.) Chiropractors were associated with a longer duration of treatment, while physical therapists were associated with lower costs, shorter duration of treatments and no patients having surgery. Patients should be aware that the decision of what medical professional to see first is their own, but seeing a physiatrist or chiropractor may lead to higher costs and longer treatment than a physical therapist.

Educating patients on low back pain reduces their fears and concerns

Many patients with low back pain experience higher-than-normal stress levels due to their condition. Reassurance is a core aspect of medical practice that is meant to reduce or remove patients’ fears and concerns about their illness, but there are no specific guidelines on how to accomplish this in patients with low back pain. One possible common-sense approach is to better educate patients on their condition and more clearly explain their symptoms, yet somehow evidence is conflicting on this strategy. For this reason, a review of studies was conducted to determine what role education plays on helping patients improve. Results showed that education indeed helped to reassure patients with low back pain about their condition, and even reduced their number of visits to the doctor. This study presents further evidence of the importance of education in helping patients understand their condition and what it entails while working towards improving.

Certain factors may influence how long it takes
patients to recover from low back pain

Patients with low back pain are usually treated conservatively – without the use of surgery – first before other options are considered. Though many of these patients improve, there is a large amount of variability in the levels of pain and disability they experience after treatment. It’s not entirely clear which factors help determine whether or not a patient will improve from treatment, so a study was conducted to learn more about these variables. Results showed that patients who had pain for more than five days and those who had negative beliefs about their low back pain were less likely to recover within 12 weeks of treatment. This suggests that starting treatment as early as possible and addressing misconceptions that some patients have may improve their chances of having a successful outcome.

Goals of patients with low back pain
don’t align with those of doctors

Low back pain is one of the most painful common conditions out there, and when it lasts for three months or more, it’s classified as chronic. When treating chronic low back pain, medical professionals use a standardized set of outcome measures to determine if their methods are successful or not; however, it’s suggested that these measures do not always line up with those of the patients. To investigate this matter in greater detail, a study was conducted on 20 patients with chronic low back pain to determine their opinions and goals of treatment. Results showed that patients’ goals varied greatly and were idiosyncratic, meaning many were unique to each patient. When they were compared to the outcome measures used by medical professionals, none were shared in common. These results show patients with chronic low back pain have different views and goals than the medical professionals treating them, and efforts should be made to ensure that the two are more closely aligned.

Low back pain patients who get imaging
tests more likely to have additional treatments

Poor sleep quality could make it
more difficult to improve for patients with neck pain

Patients with neck pain often experience sleep issues as well, and the relationship between the two conditions may work both ways, as lack of sleep could worsen neck pain. While a connection seems to exist between them, no cause-and-effect association has yet been proven, which led to a study on people with neck pain. The results – which were taken from questionnaires given over three months – suggested that the poorer the sleep quality, the worse the neck pain was for patients. This could mean that improving sleep habits may have a positive effect on reducing neck pain, and may therefore be an important area of interest for future treatments.

Obesity and reduced physical activity
are risk factors for low back pain

Obesity and low back pain are two common conditions that both negatively impact health and quality of life in their own ways. Though there is some evidence that obesity leads to low back pain, it has not yet been consistently proven, and the relationship between the two is not completely clear. For this reason, a study was conducted on a large sample of people to help better understand this potential association. Results showed that being overweight and not getting enough physical activity were defined as risk factors for low back pain, and when combined, the risk for developing it was even higher.

Surgery not necessarily better than non-surgical treatment for LBP

Low back pain (LBP) is one of the most common disorders and leading causes of disability in the world, as up to 80% of all people will experience it at some point in their lives. Non-surgical, or conservative treatment, is often the best course of treatment for LBP, but in some extreme cases that don’t improve, a surgery called lumbar fusion may be ordered. The research on lumbar fusion for LBP is conflicting, though, and based on this, a powerful systematic review was performed using all available literature on the topic. Outcomes of the review found only a minor advantage of lumbar fusion over conservative management of LBP, and researchers suggested that patients give both options equal consideration when making treatment decisions for these cases of LBP.

Specific guidelines highlight importance of
different exercises for chronic neck pain

Chronic neck pain, meaning it’s persisted for three months or more without improving, is a common condition that about 14% of Americans currently have. Physical therapy and exercise are often prescribed as effective treatments for chronic neck pain, but specific guidelines as to the time and duration of these treatments is not well defined. Therefore, a powerful review of literature called a meta-analyses was performed to better establish guidelines for treatment. Results showed that exercises should be performed in sessions of 30-45 minutes, three times a week for 12 weeks, and that variation in exercise type was the most important component for an effective program.

Physical therapists offer better management strategies
for low back pain than family practitioners

Low back pain (LBP) is one of the most common causes of pain in the U.S., and it has a reputation for regularly leading to absenteeism and long-term disability in the military. In most of these cases, LBP has historically been treated by family practice physicians, but research has shown that early access to physical therapy may be more beneficial. A study therefore compared the treatment strategies of physical therapists to physicians for treating LBP patients in the military. Results showed that physical therapists were more likely to prescribe the proper drug treatments and were more in-tune with the motivation levels and desires of patients than physicians. Based on the one-on-one, personal nature of physical therapy, it appears patients may be more likely to experience positive outcomes from these effective management strategies.

Physical therapy reduces the likelihood of surgery
for lumbar spinal stenosis patients

Lumbar spinal stenosis (LSS) is considered one of the leading causes of low back pain, and it is particularly common in older adults. Physical therapy is often prescribed to treat LSS, but it’s not clear how effective it is for reducing the likelihood of surgery. For this reason a study was conducted on LSS patients, some of which received physical therapy and others that did not. Results showed that patients treated with physical therapy within the first six weeks of their diagnosis experienced significant improvements and were less likely to have surgery. Read the full article for more details of this study.

Moderate or vigorous physical activity in leisure time
may lead to less low back pain and disability

Low back pain (LBP) has long been one of the most bothersome and prevalent conditions in the general population. Physical therapy is an effective treatment option for LBP that leads to some improvements, but they are usually only moderate, and few cases of LBP are completely cured. A new strategy for combating LBP has been to identify factors that might lead to its development, and then create recommendations based on them. A recent study looked into physical activity during leisure time, which is considered one of these factors. Researchers found that those who spent their leisure time engaged in moderate-to-vigorous physical activity had significantly less pain and disability than those who spent much of their time sitting. Therefore, since it’s healthy and it may also alleviate LBP, regular physical activity is strongly recommended.

A basic exercise program can help prevent
low back in office workers

For the majority of people with office jobs, a great deal of the day is spent sitting. As a result of the lack of mobility that comes with sitting for prolonged periods, joints can stiffen up and conditions like low back pain (LBP) may arise. Fortunately, there are ways to reduce the likelihood of painful conditions, and one of the best ways is by participating in a stretching exercise program designed by physical therapists for office workers. A recent study evaluated the effectiveness of such a program and found that it reduced the number of episodes of LBP in the office by a significant amount. Therefore, it appears one of these basic and inexpensive programs could be a beneficial strategy to prevent LBP in the workplace.

Reaction to standing for prolonged period can predict
development of low back pain

Up to 80% of Americans will experience at least one episode of low back pain (LBP) at some point in their life. While there are many factors that can influence the likelihood of this occurring, having a job that involves long periods of standing may be one of the stronger predictors. To get a better sense of just how strong a predictor it is, a study evaluated patients after standing for two hours. Those who experienced pain during that time ended up being more likely to experience an episode of LBP over the next three years. The study also found that these patients were less likely to develop LBP if they underwent an intervention program from a physical therapist. For these reasons, people with jobs that involve prolonged standing can seriously benefit from an exercise program that will lower their chances of experiencing LBP in the future.

Exercise program reduces occurrence
of neck pain for office workers

Office workers who spend most of their day sitting in a chair put extra strain on the neck that can be dangerous, and as many as 69% of these people will experience some form of neck pain every year. One option to help those who sit in a chair for extended periods of time is a prevention program, which uses stretching exercises and endurance training to improve the necks of these workers. To test this out, one study evaluated the effectiveness of this type of program and found it significantly reduced the occurrence of neck pain in office workers, meaning it could be a great way to help the many people who fall into this category avoid neck problems.

Low back pain further exacerbates depression symptoms

Depression and low back pain independently account for some of the most common clinical conditions in the U.S., with depression ranking 11th and low back pain fifth for yearly physician visits. When experienced together, the effects are likely to be even worse, as both conditions negatively impact one another. One study evaluated the prevalence of the two conditions together and found that many patients with depression also suffer from low back pain. As a result, it’s strongly recommended that low back pain and depression be treated together with conservative care management, which uses a strategy that focuses on both conditions collectively to achieve better outcomes.

Non-surgical treatment just as effective as surgery
for chronic low back pain

Lumbar fusion, a surgical procedure that causes two spinal bones (vertebrae) to grow together, is one of the most common types of back surgery and is often used to treat low back pain. Despite the fact that it’s used so frequently, there is no evidence that shows lumbar fusion is any better than avoiding surgery and treating back pain with other interventions like physical therapy instead. To compare these two options head-to-head, a massive review called a meta-analysis was performed between lumbar fusion and non-surgical (or conservative) treatment for low back pain. Results from the analysis did not find surgery to yield any greater improvements than conservative treatment, which should in effect cause patients to evaluate their options wisely when considering surgery.

Research shows patients with low back pain should see
physical therapists early, even if physicians tell them to wait

Low back pain is easily one of the most common and problematic ailments for the worldwide population, and what makes matters worse is the fact that there’s no simple or commonly-agreed upon solution. Most patients see a physician first, and from there, may try medications, injections or physical therapy (PT), and in severe cases, are sent to surgery. While research and many medical professionals support PT, a number of physicians generally don’t recommend it at all or tell patients to delay going. In an attempt to get the facts out there for low back pain patients and physicians who aren’t supportive of PT, a massive study was conducted. Results showed that only a small number of patients (7%) actually went to PT, and the ones who went earlier improved more than the ones that went later on. Read on to see why going to PT early could be your best bet if you have low back pain.

Exercise therapy program can help lift the burden of neck pain for office workers

Following low back pain, the most prevalent musculoskeletal condition in the U.S., neck pain also ranks highly on the list of common, debilitating disorders out there. For those who work in an office and sit at a desk on a regular basis, neck pain occurs even more regularly, with roughly 43-69% of all office workers experiencing pain in the past year. To attempt to curb this trend, measures have been made to reduce neck pain for office workers, and exercise therapy is one intervention growing in popularity. Investigating all available literature on the topic, it was found that muscle strengthening and muscle endurance exercises can help reduce the intensity, duration and discomfort of neck pain. Therefore, instilling a program such as this for office workers suffering from neck pain can relieve employees and improve productivity in the workplace.

Temporarily stopping participation and starting a rehab program
effective for young soccer players experiencing back pain

Though soccer doesn’t experience the same popularity levels in the U.S. that it does internationally, it’s still the most widely played sport in the world, with participation numbers that only continue to grow. Consequently, the rate of injuries sustained by soccer players also continues to increase, especially in the spine. Spondylolysis, which results from a stress fracture to a vertebra, is the most common condition that leads to low back pain (LBP) for soccer players under 18, making it an important disorder for young players. In an effort to determine an effective strategy for dealing with this condition, a study found that temporarily halting participation in sports and beginning a conservative rehab program (free of surgery) was extremely beneficial for young soccer players and greatly facilitated their return to sports.

Regular smokers shown to improve less
following back surgery than nonsmokers

The negative impact of being a habitual smoker has never been underplayed, particularly when it comes to lung health and cancer. In addition to those risks, however, smoking can also lead to more complications and slower recovery following certain types of surgery. To determine how great these risks are, a study evaluated the recovery of a number of patients following lumbar spinal surgery, and found smokers to improve less, with more pain and a lower quality of life than nonsmokers, adding more reasons to the laundry list of potential pitfalls of smoking regularly.

Physical therapists need to treat psychosocial
factors in addition to physical ones

Most patients enter a physical therapist’s office with a physical ailment of some sort, and intend to be treated primarily for that particular ailment. While this is the major concern for physical therapists (PTs) and should remain as such, a recent issue of Physical Therapy magazine stresses the importance of treating the “whole” patient, and the necessity of addressing their psychosocial issues associated with their condition to ensure the best possible outcome. Treating an injury or condition is a process that triggers a number of emotional responses, and, according to the issue, PTs need to keep them in mind and tend to them while treating patients. This sort of shift can mean better overall results and more patient satisfaction, both of which are sought after by all PTs.

Thinking about seeing a chiropractor for your low back pain?
Read this report and think again.

The high occurrence rates of low back pain (LBP) and the hindrances it causes on peoples’ lives continue to be well documented, and those who suffer from it continue to seek any form of treatment that may be effective in alleviating their pain. One of the most popular interventions Americans use is to see a chiropractor, who will use manipulation and a number of other methods to treat LBP. Yet despite their common usage in the U.S., the evidence of a chiropractor’s effectiveness is limited. Looking into this matter further with the intent of drawing more definitive conclusions, a review of available information on the subject actually found no meaningful effects of chiropractic interventions on LBP in the long-term, leading to more questions than answers on the usefulness of chiropractics.

Doing away with the concept of ‘diagnosis’ could be the key in
optimizing treatment for axial neck pain

Axial neck pain, one of the three major types of neck pain, is a musculoskeletal disorder (affecting both the muscles and bones) that’s limited to pain in the neck only. Unfortunately, when it comes to diagnosing axial neck pain and determining how to treat it, many spine specialists differ in their approach, using only the types of tests they know will confirm the treatment they wish to recommend. As a result, patients are put through a number of expensive and sometimes unnecessary tests that may or may not even help in better defining their condition. The problems with this system lie primarily in the lack of uniformity of spine clinicians, who continue to do things their own way even if they’re not proven to be effective. Many researches believe the flawed system needs to be overhauled entirely, and one possible change that’s been gaining some popularity is to nix the term “diagnosis” altogether, and instead use a series of clinical prediction rules that will highlight specific characteristics in patients that will determine which treatments will lead to the best possible outcome for each subject.

Insider’s perspective from those with low back
pain claim it never fully goes away

Low back pain (LBP) continues to affect the lives of millions of Americans on a regular basis, preventing many from engaging in everyday activities and leading a normal lifestyle. Efforts have been made to be better understand LBP and the reason it reoccurs so often, but there is still not a universal system for measuring its recurrence rates. Some measurements take into account time off work and health-care utilization, but questions exist as to if those figures accurately depict the bigger picture of LBP. A group of researchers noted this and thought it would be beneficial to hear from LBP sufferers in an open-forum discussion to get a sense of how it impacts their lives. The overall consensus showed that most with LBP felt it was an ongoing condition that comes and goes in varying degrees, but never fully goes away. Health care use was minimal since participants felt it never actually helped their pain, and work was only missed in extreme situations. These findings suggest that time off work and health-care use aren’t effective measurement statistics, and that treatment strategies need to be improved significantly.

Early physical therapy treatment for low back
pain can prevent future complications

Low back pain (LBP) is one of the most common disorders found throughout the world, with about 65-80% of adults experiencing the condition at some point in their lifetime, making it an urgent and pressing matter to address with the best possible treatment. Physical therapy administered early on is regarded by most as the leading treatment method available, but there are some medical professionals who question its effectiveness and choose to treat it by other means. Seeking definitive answers, a study was conducted that compared early PT to a number of other interventions and found it to be effective in reducing the likelihood of receiving costly procedures like injections and surgery later on in the course of LPB.

How healthcare professionals’ word choice affects
patients’ perceptions on low back pain

Low back pain (LBP) continues to affect countless individuals throughout the globe with distress and discomfort, and remains a major concern of health-care professionals. In addition to the physical aspects that are largely responsible for LBP, there are also some psychosocial factors that can contribute to it and create negative beliefs about the condition. For this reason, the word choice used by physicians to deliver news to patients is of utmost importance, as it can shape patients’ views and potentially lead to the condition worsening. A study investigated the role of word choice in a clinical setting and found direct correlations between certain words and inappropriately negative outlooks, which means physicians should be much more cognizant about the manner in which they deliver messages to patients.

How characteristics of swinging mechanics
can lead to low back pain for golfers

Golf is a sport that enjoys wide-ranging popularity on an international scale due to its casual nature and mild intensity level. Despite the fact that golf doesn’t require much energy exertion and is fairly safe compared to most other sports, injuries still do occur, with lower back pain (LBP) being the most common complaint for both professional and amateur golfers. Consequently, physical therapists have been investigating which characteristics, if any, in a golf swing could contribute to a more likely chance of a golfer experiencing low back pain and why. One study compared golfers with LBP to those without it, and found a number of indicators that may lead to LBP that can be avoided if addressed properly.

Many patients with low back pain fail to follow
recommendations for improvement

Low back pain (LBP) is an extremely common condition and major source of discomfort that affects a large percentage of people throughout the world at some point in their lives. When not treated correctly, cases of LBP can go on to turn more extreme and pose future problems that could’ve been avoided if guidelines were followed properly by patients. Noting this, an Australian study surveyed patients with LBP and found that many of those suffering from the condition didn’t seek advice, and of those that did, a significant amount didn’t actually follow the recommendations given to them. This figure points out much of what’s wrong with the overall face of LBP rehab and should be considered in moving forward.

A close look at hyperkyphosis: how it develops, how to manage it

Age-related hyperkyphosis, which is defined by an exaggerated curvature of the thoracic spine, is a common condition in the elderly population that impairs the ability to function properly and increases the risk of falls and fractures. Though it effects somewhere between 20-40% of senior citizens, the natural history of hyperkyphosis is not completely understood, and it’s thought to come about from a variety of processes. Fortunately, if hyperkyphosis is identified and treated early in its onset, the chances of recovering from it are much more likely. Take a look at what can cause it and the best ways to treat hyperkyphosis if it occurs.

Full-scale evaluation of lumbar spinal
stenosis surgery for older adults

Spinal stenosis, a condition in which the narrowing of the spinal cord causes nerve pinching and subsequent pain in the buttocks, is the most common indicator for spine surgery in older adults, which itself is extremely prevalent. Despite the popularity of the surgery, however, a general consensus on the best surgical method has yet to be reached, as many surgeons still take their own individualized approach. To investigate these various methods and to clarify which is the best option, a study was conducted that evaluated Medicare trends to determine the optimal surgical style.

Hip impingement: recognizing, understanding and
treating a common cause of hip pain

Based off the recent progress in diagnosing and treating nonarthritic hip injuries, hip impingement has become increasingly recognized as one of the more common causes of hip pain for athletes, adolescents and adults. Caused by a bone in the hip and the thighbone rubbing against each other, hip impingement can lead to the wearing away of cartilage and eventually osteoarthritis if not treated properly. The debilitating disease can have serious implications for both physical and daily life activities, but physical therapy has been strongly recommended as a method to treat it.

Hip arthroscopy for athletes in the long
term: a 10-year follow up

Arthroscopy is a minimally invasive procedure preferred by some for its shorter recovery time and smaller scar, and it has been a popular method to treat sports-related hip problems for years. Despite the popularity of hip arthroscopy, there is a lack of data on the long-term effects of the surgery, spurring a study in which athletes who underwent the procedure were monitored over the course of 10 years to determine its effectiveness or lack thereof.

Beyond heavy backpacks and computer overuse:
Lower back pain in adolescents

Now that lower back pain has become a malady not only experienced by the adult population, but by adolescents as well, concerned parents are interested in the exact causes of so many back-related issues. Though wearing a heavy backpack and spending too much time slouched over in front of the computer screen have taking most of the rap, and with fairly good reason, back problems for most adolescents are rooted much deeper.

Wheeling back to health: Wheeled walkers may relieve pain
for Spinal Stenosis patients

Many elders who suffer from Lumbar Spinal Stenosis (LSS), a condition characterized by the narrowing of the spinal canal, have a tendency to lean forward on shopping carts and other similar devices to alleviate pain. A study conducted on elders with LSS determined that the forward leaning motion is actually helpful for the spine, and came to recommend wheeled walkers for the condition as it encourages the walker towards this motion, opening up the spine and relieving pain.