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At 09:28 AM 2/24/99 -0500, you wrote: >Owen: > >Is there any evidence that conclusively supports what you seem to imply - >i.e. that physio is HIGHLY effective for low back pain? Feel free to use >any specific pathology that can be definitely ascertained by a physical >examination.Best of luck mate!! The BEST studies that I have seen were studies performed by the Department of Family Medicine Uppsala University, Uppsal Sweden. The primary researcher was Stefan Blomberg. They are published in book form under the title "A pragmatic approach to low-back pain including manual therapy and steroid injections: A multicentre Study in pPrimary Health Care" ACTA UNIVERSITATIS UPSALIENSIS Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 394, 1993. The specific articles are as follows Blomberg S, et al. A controlled, multicentre trial of manuall therapy in low-back pain; iniitial status, sick-leave and pain score during follow-up. Scandianaviouan Journal of Prmary Health CAre 1992; 10:170-78 Blomberg S Eet al. A randomized study of manual therapy with steroid injections i low-back pain; telephone interview folow-up pain, disabliity, recovery and rug consumption. European Spine Journal 1994;3:246-54 Blomberg S, et al. Manual therapy with steroid injections-a new approach to treatment of low back pain; a controlled multicenter trial with an evaluation by orhtopedic surgeons. Spine 1994;19:569-77 Blomberg S, Tibblin G. A controlled, multicnetre trial of manual therpay with steroid injections in low back pain; function variables, side effects and complications during four months follow-u. Clinical Rehabilitation 1993;7:49-62 Blomberg S, et al. manual therapy with steroid injections in low back pain; improvement of quality of life in a controlled trial with four months' follow-up. Scandinavian Journal of Primary Health Car 1993;11:83-90 This was a very interesting series of well performed research that suggests a "pragmatic approach". In other words, treatment must take into account that back pain has multiple etiologies. Other studies that I don't have in front of me are the studies so often cited by chiropractors on the efficacy of "manipulation" on acute back pain. The studies which were referenced were actually studies performed in England by PHYSICAL THERAPISTS using Maitland mobilization techniques (as I remember the studies). Since so many members of this board are based in England, maybe someone could give those references--I don't have them off hand. Hope this helps clear up that there are studies that show statistical and clinical evidence of the efficacy of physical therapy (the studies although stating "manual therapy" actually used a mutltifaceted approach of PT including exercise...Also, the number of injections used was less than an average of 1/patient--this people were not given a lot of cortisone. >I'm not being a smart__se, but the conclusion that PT is not that great is >quite reasonable, based on the research so far. > > >Michael Meddows >Virginia Beach > >-----Original Message----- >From: Owen Allen [SMTP:[log in to unmask]] >Sent: Wednesday, February 24, 1999 4:43 AM >To: [log in to unmask] >Subject: Re: BACK CARE BIAS? > >At 22:58 22/02/99 -0500, you wrote: >>..." But this is really not exactly fair. If I had a tumor, a >>kidney infection, etc, that caused back pain, I am sure I would be more >>satisfied with an MD. If I had a herniated disk unresponsive to >>chiropractic care or physical therapy, I would be more satified with a >>ortho or neuro surgeon. If I had "garden variety" low back pain, I would >>be most satisfied with doing some home exercises and walking either with >>instruction by a PT or a DC or an MD". >--------------------------------- >In similar vein, last year I read a brief of a research report from a >professor of General Practice in Canada who purported to have studied the >effect of physiotherapy on low back pain, and found the efficacy to be low. >I was baffled by the suggestion in this report that 'physiotherapy' is a >treatment technique or protocol, and that low back pain is a specific >pathology. It is of great concern that leaders of health sciences either >fail to be rigorous in the definition of their research variables, or their >communication of that research. Whichever the case, in this era of >information it is a failure of duty of care for scientists to be that >sloppy. Although I would go so far as to suggest that some researchers >might >be downright mischievous, for their own gain. > > >Owen Allen >Atherton Hospital >P.O. Box 183 >Atherton 4883 >Queensland, Australia. >Ph: 07 40910261 >F: 07 40913502 > Herb Silver %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%