Early treatment for low back pain leads to less pain

Patients with subacute low back pain who received early access to physical therapy showed more improvement in perceived pain at 6 months than did those whose intervention was delayed, says an article in the July-August (2006) issue of Clinical Journal of Pain (Vol 22, No 6). Objectives of this study were to evaluate the effects of early access (EA) to physical therapy treatment for patients with subacute low back pain and compare them with effects of access to treatment after a 4-week wait. Sixty patients with subacute low back pain from a primary care facility in Sweden were assigned randomly to either to EA within 2 days for physical examination and individualized physical therapy treatment (n=32) or a control group placed on a 4-week waiting list (n=28). Subacute low back pain was defined as duration of symptoms for 3 to 12 weeks. Self-administrated questionnaires were used for assessment at inclusion, at discharge, and at 6 months after discharge. The primary outcome measure was pain intensity assessed by the Borg category scale for ratings of perceived pain. Secondary outcome measures included the Orebro musculoskeletal pain screening questionnaire, the Roland and Morris disability questionnaire, sick-leave, visits to health care, and physical therapy. The results showed no significant differences in pain between the groups at discharge. At 6 months, the reduction of pain was significantly greater in the EA group compared with that of the control group. Changes in secondary outcome measures were not significantly different between groups. The article noted that early access to physical therapy could be introduced without additional resources by reorganizing the way services were provided.

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