The use of a back class teaching extension exercises in the treatment of acute low back pain in primary care.
BACKGROUND
Back extension exercises are commonly recommended to treat acute low back pain. Evidence of their beneficial effect is, however, weak.


OBJECTIVE
We aimed to demonstrate a benefit of teaching back extension exercises in addition to usual GP care for acute low back pain.


METHODS
Patients with acute simple low back pain of less than 28 days duration, presenting to a GP, were randomized either to attend a back class or to receive conventional management. Outcome was measured using changes in the Oswestry disability score and visual analogue pain scale (VAS) on six occasions during 1 year and also a VAS and patient assessment of degree of disability during the previous 6 months at 1 year.


RESULTS
Seventy-five patients were recruited. The principal outcome measures showed no difference between the two groups. The treatment group reported less chronic disability at 1 year (50% versus 14%, P < 0.007).


CONCLUSIONS
A treatment effect has not been demonstrated, but some patients who would otherwise have reported mild pain were pain free after 1 year. This approach to treating back pain has not been shown to be effective. More much larger studies, with more intensive treatment, are required in order to decide whether physical therapy in primary care is beneficial as treatment for acute back pain.
Underwood
M R
MR
Centre for Primary Care, Department of Postgraduate Medicine, University of Keele, UK.
Morgan
J
J
D000208:Acute Disease; D000328:Adult; D005081:Exercise Therapy; D005194:Family Practice; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D016896:Treatment Outcome