Back pain
Facts and Myths about Back Pain Treatment
- Spinal manipulation - is safe and effective for patients in the first month of acute low back symptoms without leg symptoms. For symptoms lasting longer than 1 month, efficacy is unproven.
- Traction - no role in acute low back pain.
- Physical modalities - massage, diathermy, ultrasound, TENS, hot or cold therapy have no proven efficacy in the treatment of acute low back symptoms.
- Invasive techniques - facet joint injections, epidural steroids have no proven efficacy.
- Lumbar corsets - no role; may potentate deconditioning of spinal musculature.
- Bed rest - more than 3days leads to debilitation and muscle weakness and stiffness. Itis not recommended for treating low back problems.
- Exercise - low impact aerobic exercise can prevent debilitation due to inactivity; ( walking, biking or swimming). Conditioning exercises for trunk muscles (back extensors), are helpful after two weeks of aerobic exercise. Evidence does not support a benefit from back specific exercise machines over traditional exercise. We favour core strengthening exercises like Pilates and Yoga.
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