Back pain and physiotherapy

doi:10.1136/bmj.329.7468.694

BMJ 2004;329:694-695 (25 September), doi:10.1136/bmj.329.7468.694

Editorial

Back pain and physiotherapy

NHS treatment is of little value

The first 150 words of the full text of this article appear below.

My next patient: looking hopeful, hobbling in. Six weeks ofpain and no respite. Referral to physiotherapy was the obviousoption for such patients, but now I know from a paper in thisissue that providing routine physiotherapy in the NHS is nobetter than advice to remain active (p 708).¹ Six weeks is along time to be in pain, unable to work, and relatively immobile.Most patients will still be experiencing low back pain and relateddisability one year after their first consultation, and unfortunatelywe can do little about it.^w1 Although in this study patientsfelt better, objective outcomes did not improve—and, ina resource limited health service, can we make referral decisionsbased on subjective measures?¹

What are the implications for physiotherapy? Not all interventionscan stand up to critical appraisal,² and this paper shows thatour traditional model of physiotherapy for back pain . . . [Full text of this article]

Domhnall MacAuley, general practitioner

Hillhead Family Practice, 33 Stewartstown Road, Belfast BT11 9FZ (domhnall.macauley@ntlworld.com)

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