Patient Education: Diseases Conditions Treatments & Procedures

Back pain

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.