Interventions for the Management of Acute and Chronic Low Back Pain
Patient Guideline Summary
- We will use the abbreviation LBP throughout this summary to refer to low back pain.
- LBP is usually caused by trauma or overuse. Back surgery may require subsequent physical therapy for optimum results.
- Symptoms include pain in the low back sometimes extending into a leg and impaired movement.
- This patient summary focuses on physical therapy methods for treating LBP, both acute and chronic.
- Treatment can improve strength and function as well as reduce pain.
- A treatment plan contains multiple elements over time as you improve.
- Exercise training interventions include specific trunk muscle activation, strengthening, and endurance
- Movement control
- Trunk mobility exercise
- Aerobic exercise
- Aquatic exercise
- General exercise
- Thrust or non-thrust joint mobilization
- Massage or soft tissue mobilization
- Dry needling
- Neural mobilization
- Strength training
- Active education strategies:
- Advice related to exercise
- Advice about staying active
- Pacing strategies
- Neuroscience education regarding pain
- Passive strategies (i.e., access to educational materials).
- For those undergoing discectomy or de-compression surgery:
- Post-surgical precautions
- Resuming physical activity
- Physical therapy combines treatment with education, each program directed to the unique needs of the individual patient.
- There are several treatment protocols developed and standardized for LBP:
- Treatment-based classification (TBC)
- Multidimensional clinical framework
- Cognitive functional therapy (CFT)
- Movement system impairment MSI
- Mechanical Diagnosis and Therapy (MDT)
- Prognostic risk stratification
- Pathoanatomic-based classification
- Mechanical traction for patients with chronic LBP with leg pain is not recommended.
- APTA: American Physical Therapy Association
- CFT: Cognitive Functional Therapy
- LBP: Low Back Pain
- MDT: Mechanical Diagnosis And Therapy
- MSI: Movement System Impairment
- TBC: Treatment-based Classification