THE USE OF A BACK CLASS TEACHING EXTENSION EXERCISES IN THE TREATMENTOF 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. Objectives. We aimed to demonstrate a benefit of teaching back extension exercises in addition to usual GP care for acute low back pa in. 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 pa in scale (VAS) on six occasions during 1 year and also a VAS and patie nt assessment of degree of disability during the previous 6 months at 1 year. Results. Seventy-five patients were recruited. The principal o utcome measures showed no difference between the two groups. The treat ment 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 p ain free after 1 year. This approach to treating back pain has not bee n shown to be effective. More much larger studies, with more intensive treatment, are required in order to decide whether physical therapy i n primary care is beneficial as treatment for acute back pain.