Jennifer Kendall, PharmD, is busy, so the sound of children's laughter in the pharmacy just barely registers. Her technician rifles through the prescription orders that have been faxed in and extracts a couple. "Ms. Healow is here, and maybe we could do these first so her children don't take the place apart, hmm?" she says.
Are researchers on the verge of "solving" the back pain problem? This might be a stretch, but there was a notable sense of optimism about the management of low back pain and low back pain disability at this year's International Forum for Primary Care Research on Low Back Pain in Israel.
As the discussions below indicate, many researchers are hopeful that the back pain crisis in Western societies will begin to abate, in response to rational, evidence-based management approaches.
A recent review has concluded that: "Initial studies have found massage to be effective for persistent back pain. Spinal manipulation has small clinical benefits that are equivalent to those of other commonly used therapies. The effectiveness of acupuncture remains unclear. All of these treatments seem to be relatively safe. Preliminary evidence suggests that massage, but not acupuncture or spinal manipulation, may reduce the costs of care after an initial course of therapy" (Cherkin et al., Ann. Int. Med. 138(11) (2003) 898).
About 70 to 80 percent of adults will be affected by low back pain during their lifetimes.1 Physiotherapists have several treatment options that can help patients with LBP whether due to degenerative disc disease or a variety of other causes. Physical therapy and manual therapy including spinal manipulation and patient education to remain active and use appropriate body mechanics can have positive effects and is beneficial for patients with LBP.2, 3 Physiotherapists are trained to identify which of these treatment strategies will be most effective for an individual patient, which further improves the effectiveness of care.