Physical therapy for patients with low back issues led to a decrease in pain and increase in function for some, according to new research, but treatment was more likely to fail in smokers and workers’ compensation claimants.
The retrospective study, which was published online last week in the journal Spine, included 4,597 patients who underwent physical therapy for the non-operative treatment of low back pain. The study’s lead author was orthopedic surgeon Dr. Ananth Eleswarapu of the University of Chicago Medical Center.
Using the Oswestry Disability Index as a measure, 28.5% of patients with low back pain showed improvement following physical therapy. The presence of night symptoms, obesity and smoking were predicators of treatment failure as measured by this method.
When the Numeric Pain Rating Scale was used while patients were at rest, 59% showed improvement following physical therapy. Workers’ compensation status, smoking and obesity were among the factors associated with treatment failure.
Similarly, 60% of patients showed improvement in the Numeric Pain Rating Scale during activity after physical therapy. Workers’ compensation status, smoking and night symptoms were predictive of treatment failure, according to the study.
The authors noted that although low back pain is a major cause of disability among patients, previous studies have found poor efficacy for surgery except in specific circumstances. But physicians lack evidence to guide them regarding the variety of non-operative treatments, they said.
The authors concluded that a substantial percentage of patients with low back pain did not show clinically important improvement in pain or function following physical therapy.