Evidence in practice — number 5: back pain

THE EVIDENCE

Frost H, Lamb SE, Doll HA et al. Randomised controlled trial of physiotherapy compared with advice for low back pain. BMJ 2004; 329: 708.

BACKGROUND

Some have argued that the continuing focus on routine NHS physiotherapy services for patients with low back pain has more to do with fear and inertia than with evidence. For most GPs faced with a patient with low back pain, initiating a physiotherapy referral is easy. However, in circumstances where health resources are limited it is important to be confident about the evidence underpinning any intervention, whether it is pharmacological or non-pharmacological.

Physiotherapy for back pain cost the NHS £251 million in 1998.

STUDY DESIGN

This was a pragmatic randomised controlled trial. The study involved 286 patients with low back pain referred to 76 physiotherapists …