From The Ergoweb® Learning Center

Australian Study Endorses Basic Treatment for Low Back Pain

Low back pain is one of medicine’s most perplexing afflictions, but an Australian study suggests the remedy is simple. The researchers question the need for the expensive and potentially risky treatments that are commonly prescribed, and say relief is a matter of the basics – staying active, avoiding bed rest and taking paracetamol.

The painkiller is known as acetaminophen in the United States.

The basic advice, supported by other studies, has found its way into physicians’ guidelines, but non-steroid anti-inflammatory drugs (NSAIDs) such as diclofenac and spinal manipulation are often recommended as next-stage management options.
Researchers at the Back Pain Research Group at the University of Sydney followed 240 patients suffering from acute low back pain from their first visit to their physician through to recovery. They assigned the patients to receive either diclofenac, a dummy drug, spinal manipulation or fake manipulation therapy. Writing in British medical journal, The Lancet, study leader Mark Hancock and colleagues reported that patients who had the basic advice to stay active and take paracetamol got better just as quickly as those who were given the basic advice plus the stronger painkiller and spinal manipulation.

They wrote that findings “from the secondary analyses support the primary analyses, showing no significant effects on pain, disability or global perceived effect at one, two, four or 12 weeks when diclofenac or spinal manipulative therapy or both were added to baseline care." The researchers also noted that NSAIDs and spinal manipulation are associated with adverse effects.
Almost all the patients had recovered by the end of the study no matter what treatment they had received.
Dr Stuart Derbyshire, senior lecturer in the School of Psychology and expert in pain at the University of Birmingham, agreed with the findings. "For most people, providing simple care and advice should guide the patient through their acute phase of pain and allow them to return to normal life when that acute phase is over," he explained in an article on the Australian study by the BBC, one of several news organizations that reported the Lancet study. 

Sources: The Lancet; BBC