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Back pain is prevalent and reduces quality of life in population

Back pain is a prevalent condition in the entire population, as 80% of people will experience it at least once. It's particularly common in older adults, and up to 33% of individuals over the age of 65 experience it regularly, which limits their abilities and reduces quality of life. As the U.S. population continues to age, the number of cases of back pain and need for effective treatment will both continue to grow. Physical therapy is commonly used to address these physical limitations in older adults, but its overall impact on pain and function is unknown. For this reason, a study was conducted to investigate the association between the type and amount of physical therapy on disability and pain in older adults with back pain over one year.

Large group of older adults evaluated with series of questionnaires

Over 5,000 older adults who sought care from a doctor for new back pain were screened, and 3,771 fit the criteria and were used for the study. These participants were evaluated three, six, and 12 months after their initial visit with questionnaires that covered outcomes such as pain, disability, and quality of life. Physical therapy interventions were also recorded and categorized as active (requiring movement of patients), passive (no patient movement) or manual (performed by physical therapists hands). Finally, the amount of physical therapy used over the one year was classified as none, low (1-4 sessions), medium (5-9 sessions), and high (more than 10 sessions).

Though improvements are small, more physical therapy reduces pain intensity

Results showed that the use of more physical therapy services and active physical therapy were most consistently associated with less back and leg pain, and a greater likelihood of pain improvements. The improvements were generally classified as small, but this was likely due to the fact that only very few patients received a high amount of physical therapy over the one year. These findings provide some useful information on the effectiveness of physical therapy for older adults with back pain; however, a higher-quality study called a randomized-controlled trial is needed to investigate this in greater detail and determine how more physical therapy will affect results and what services are most effective.

-As reported in the October '14 issue of Physical Therapy