Combined physiotherapy and education is efficacious for chronic low back pain
Open accessAbstract
Manual therapy, exercise and education target distinct aspects of chronic low back pain and probably have distinct effects. This study aimed to determine the efficacy of a combined physiotherapy treatment that comprised all of these strategies. By concealed randomisation, 57 chronic low back pain patients were allocated to either the four-week physiotherapy program or management as directed by their general practitioners. The dependent variables of interest were pain and disability. Assessors were blind to treatment group. Outcome data from 49 subjects (86%) showed a significant treatment effect. The physiotherapy program reduced pain and disability by a mean of 1.5/10 points on a numerical rating scale (95% CI 0.7 to 2.3) and 3.9 points on the 18-point Roland Morris Disability Questionnaire (95% CI 2 to 5.8), respectively. The number needed to treat in order to gain a clinically meaningful change was 3 (95% CI 3 to 8) for pain, and 2 (95% CI 2 to 5) for disability. A treatment effect was maintained at one-year follow-up. The findings support the efficacy of combined physiotherapy treatment in producing symptomatic and functional change in moderately disabled chronic low back pain patients.
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Understanding pain decreases its threat value, which leads to more effective pain coping strategies.
“Evidence shows that understanding pain decreases its threat value which, in turn, leads to more effective pain coping strategies [61,68].”
From Best-evidence for the rehabilitation of chronic pain part 1: Pediatric pain (2019) · cites this paper as [61]
The Introduction (page unavailable) says targeted education aims to change how patients conceptualise pain and reports improved pain cognitions and self-efficacy with related educational approaches. It does not say that understanding pain reduces its threat value or establish that this leads to more effective coping strategies. (LLM, conf=0.76)
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- Authors
- Moseley, L.
- Venue
- Australian Journal of Physiotherapy
- Publisher
- Elsevier BV
- Published
- 2002
- Volume
- 48
- Issue
- 4
- Pages
- 297-302
- ISSN
- 0004-9514 (ISSN-L)
- OpenAlex
- W2110582693
- Cited by
- 472
- References
- 35
- Citations by year
- 2026: 10 · 2025: 16 · 2024: 21 · 2023: 26 · 2022: 25 · 2021: 30 · 2020: 32 · 2019: 29 · 2018: 32 · 2017: 25 · 2016: 31 · 2015: 25 · 2014: 20 · 2013: 19 · 2012: 17
- FWCI
- 3.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Australian Journal of Physiotherapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy-related medical research
- Keywords
- chronic low back pain, physiotherapy, manual therapy, physical activity, patient education, pain, disability, Roland-Morris Disability Questionnaire, number needed to treat, general practitioner management, treatment efficacy, long-term follow-up
- MeSH terms
- Adult, Chronic Disease, Female, Humans, Male, Middle Aged, Pain Measurement, Patient Education as Topic, Time Factors, Treatment Outcome, Patient Satisfaction, Low Back Pain, Musculoskeletal Manipulations
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