The Latest in Low Back Pain Treatment Guidelines

Low back pain is consistently one of the leading causes of disability. As physical therapists, we are on the front lines of treating low back pain, and we are committed to following the latest research to help guide our practice. In 2021 the guidelines for acute and chronic low back pain were revised, so let’s take a look at where the research is directing us! An in-depth discussion of the findings from these clinical practice guidelines would be extensive, and boring for most of the readers of this blog. So let’s keep it simple and jump right to the point. The guidelines use an alphabetical grade to each treatment type being analyzed. You can have confidence that if a certain intervention earns a grade of an “A” or “B“ that they should be utilized. Let’s explore those top grade earners to give you an idea of how physical therapy may be able to help you.

Acute (recent onset) of Low Back Pain

The top interventions for those people with back pain of 6 weeks or less included manual therapy (grade A). “Manual Therapy” is a very broad term to use, but some examples are if you have had a therapist using their hands to help stretch or change how an area of your body is moving. Earning a grade of “B” for this group is the use of exercise training interventions including specific trunk muscle activation. In layman’s terms, we need to be more specific in this group, the use of generalized, or non-targeted, exercise will not be as effective. Also getting a “B” is education. Education is huge for this group, it is critical to understand the steps you can start taking to reduce your pain in the short term, but also, how to begin taking care of your back to promote spine health.

Chronic Low Back Pain

When your back pain is lasting longer than 6 weeks, it is called chronic. Though it is easy to lose hope when pain sticks around for too long, it is important to know that we are still successful at helping you get back to your normal self. Physical therapists should be using exercise interventions including trunk strengthening, endurance, varied exercise types, aerebic exercise, or aquatic exercise (grade A). Education, trunk mobility exercises, and some specific exercise modalities (beyond the scope of this blog to describe them) are all also recommended with a grade of B. Your therapist may also recommend some other varied exercise types including, yoga, stretching, Pilates, and strength training to supplement your other treatments, this type of treatment also received an “A”. We will want you to be moving in safe and comfortable ways and using a wide variety of exercises!

Exercise for Chronic Low Back Pain in Older Adults (60+)

You are never too old to get better! The research for this group of what they categorized as “older adults” concluded that the evidence is strong (grade A) for the use of a an exercise training to reduce pain and disability. My hope is that people do not resign themselves to a life of dealing with low back pain because they have had it for years or they feel that they are too old.

This is far from an exhaustive list of the interventions recommended. The specific exercise strategies, manual therapy techniques, treatment by classification, dry needling, and modalities were omitted to preserve the simplicity of this (intentionally) brief conversation. All in all, here at Dragonfly Physical Therapy we are staying up to date on the latest recommendations. We hope that you will consider doing something about that low back pain you have as we understand how debilitating it can be. Using some of the above techniques, we love to help our patients conquer and achieve their goals. Don’t suffer in silence. Contact us at Dragonfly Physical Therapy to schedule an appointment and start your journey towards a pain-free life!

George, Steven Z., Fritz, Julie M., Silfies, Sheri P., Schneider, Michael J., Beneciuk, Jason M., Lentz, Trevor A., Gilliam, John R., Hendren, Stephanie, Norman, Katherine S. (2021). Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. Journal of Orthop Sports Phys Ther. 51 (11): CPG1-CPG60.