Comparing three active therapies for chronic back pain

In August 2001, A.F. Mannion, J. Dvorak, S. Taimela and M. Müntener studied 3 active therapy methods for chronic lumbar back pain (“chronic low back pain”). 148 patients were assigned to one of the following therapy groups (2 sessions per week for 3 months):

1. active physiotherapy
2. trunk muscle reconditioning on training equipment
3. a general aerobic programme.

Before and after the therapy period, and again 6 and 12 months after the end of therapy, self-assessed pain and disability were recorded using questionnaires.
127 patients completed the questionnaires at all 4 time points.

The 3 treatment methods were equally effective throughout the entire follow-up period at reducing pain intensity and frequency.

Subjectively assessed disability, however, changed significantly differently between the therapy groups after the end of therapy (p=0.03).

In the physiotherapy group, disability was back to pre-therapy levels 6 months after the end of therapy, while in the two other groups the positive effect still lasted 1 year after therapy.

There were also large differences in cost; the aerobic programme was by far the cheapest. If strength training or aerobics were used as the 1st-choice therapy, treatment costs for chronic non-specific lumbar back pain could be massively reduced.

So exercise is the best remedy for back pain.