Evaluation is treatment for low back pain
Adriaan Louw1,2,3, Steve Goldrick1,3,4, Andrew Bernstetter5
1International Spine Pain Institute , Story City, IA, USA.
The Journal of Manual & Manipulative Therapy
|February 25, 2020
Summary
The initial physical therapy examination, including history taking and physical assessment, significantly reduces low back pain and leg pain. This pain reduction was most pronounced after the history-taking component of the evaluation.
Area of Science:
- Orthopedics
- Physical Therapy
- Pain Management
Background:
- The initial patient evaluation in physical therapy is crucial for diagnosis and treatment planning.
- Understanding the immediate effects of the examination process on patient-reported outcomes is important for optimizing care.
Purpose of the Study:
- To determine the impact of the history taking and physical examination components on pain and function in patients with low back pain.
Main Methods:
- An observational cohort study was conducted with 34 new patients presenting with low back pain.
- Pain levels (Numeric Pain Rating Scale) for the back and leg were measured before and after history taking and physical examination by a blinded investigator.
Main Results:
- A statistically significant reduction in pain was observed for both back (1.23 NPRS points) and leg (0.95 NPRS points) after the examination process.
- The most substantial pain reduction occurred immediately following the history-taking portion of the evaluation.
Conclusions:
- The physical therapy examination process itself yields small but significant therapeutic benefits, impacting pain, fear-avoidance, and pain catastrophization.
- Therapist-patient connection, while important, did not significantly influence these immediate outcome measures in this study.
