Physiotherapy no better than advice for back pain

Routine physiotherapy for mild to moderate low back pain is no more effective than a single advice session with a physiotherapist, finds a study in this week's BMJ.

Physiotherapists in the British NHS treat around 1.3 million people for low back pain each year, but there is very little evidence for its effectiveness. International guidelines vary but generally recommend advice to remain active.

The study involved 286 patients with low back pain of more than six weeks' duration; 144 received therapy and 142 received advice only. Level of disability was measured at two, six, and 12 months. Patient perceived benefit of treatment was also assessed.

Patients in the therapy group were more likely to report benefits from treatment, but there was no evidence of a long term effect of physiotherapy. There were no differences in disability scores between the groups at 12 months.

Routine physiotherapy seems to be no more effective than one session of assessment and advice from a physiotherapist, conclude the authors.