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Physical therapy for back pain not as good a treatment as time

Although physical therapy helped in the short term, a new study found no great difference at one-year follow-up interviews between patients who did and did not receive the treatment.

By Stephen Feller

SALT LAKE CITY, Oct. 13 (UPI) -- Early physical therapy can help patients with lower back pain, however a recent study found it was not significantly more effective than the usual care -- allowing time for spontaneous recovery.

Lower back pain can be indicative of other conditions, such as kidney stones or a fracture. Without symptoms or evidence of such a condition, however, researchers at the University of Utah found even skipping unnecessary diagnostic tests can help to alleviate the pain by reinforcing the idea that it should go away.

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The researchers said patients simply understanding they are being helped can have an effect on the pain patients feel.

Previous studies support the idea, as at least one recent study suggested talking therapy with the goal of teaching patients to deal with their pain can be as effective of physical therapy, though the physical therapy did help in many cases.

"We get into trouble and we do real potential harm to patients when we accelerate them down a pathway too rapidly and that can end in expensive, invasive procedures that patients really don't want when they start seeking care," Julie Fritz, associate dean for research in the College of Health at the University of Utah, told NPR. "People who feel that they're being treated and cared for will improve a bit more rapidly regardless of what's actually being provided to them."

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Researchers in the new study worked with 220 participants between March 2011 and November 2013, 108 of whom received physical therapy while 112 received usual care.

Patients who'd gone through physical therapy had some improvements walking, moving and lifting things after three months of treatment, but they had the same level of pain as those who'd not had physical therapy. At one-year follow-ups, researchers reported no clinically significant difference in each group's experience.

The previous study, conducted in England, found that while patients who only went through talking therapy felt they would have benefited from physical therapy as well, the researchers did not find a significant difference between groups of patients that had and had not received it.

Like the University of Utah study, however, researchers found stress played a role in the significance of people's pain. Reducing that stress, either by cutting out unnecessary tests or by teaching patients skills to overcome the pain, helped treat the lower back pain.

The study is published in the Journal of the American Medical Association.

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