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BMJ Article - CSP statement & guidance to members and the media

5 July 2005 - 9:10am

Physiotherapy intervention for mild low back pain yields faster results not different results -these are the findings of a survey to be published in the British Medical Journal 25th September 2004. The CSP issues guidance and a statement.

Physiotherapy intervention for mild low back pain yields faster results not different results

These are the findings of a survey to be published in the British Medical Journal 25th September 2004.

The survey, conducted by Sarah Stewart-Brown, Professor of Public health at University of Warwick assessed the treatment of two groups of sufferers of mild low back pain of more than six weeks in duration.  One group (142 people) was offered advice on exercise and how they could undertake management of their condition by Chartered Physiotherapists the other group (144 people) were given a range of treatments by Chartered Physiotherapists.   

The results show that after 2 and 6 months the patients who received treatment from a physiotherapist reported that they were feeling better and reported a return to greater function.  Those patients who received treatment from a physiotherapist at the earliest point saw a quicker return to function.  Those patients who received advice from a physiotherapist saw a gradual return to normal life and movement.


PHYSIO WORKS : Both groups benefited from the intervention of physiotherapy - This survey does not show that physiotherapy doesn't work - this is not a comparison of treatment vs no treatment.  Both groups had a physical assessment and advice from a chartered physiotherapist

EXERCISE HELPS MILD LOW BACK PAIN - Physiotherapists have recognised for some time that in the case of mild lower back pain that a general return to movement can be as helpful to a sufferer of back pain as manipulation or similar treatments.   This understanding has led to the establishment of telephone triage services that have been shown to be effective and popular.

MILD BACK PAIN NOT SEVERE - the findings that exercise and advice can help with mild back pain can NOT be transferred to those experiencing moderate or severe back pain.  Patients with these symptoms SHOULD SEEK MEDICAL ADVICE.

EARLY TREAMENT WORKS -The survey highlights the benefit of early treatment.  Previous research of patients with back pain has shown that they revert to a disabled lifestyle within 48 hours and that early intervention prevents chronic back pain.

EARLY TREATMENT HELPS RETURN TO NORMAL LIFE - Sufferers of back pain may consider that experiencing back pain for longer with gradual relief is less desirable than seeking treatment that can speed up recovery and ensure a return to normal life and movement.  This can mean sufferers can return to work or other activity - enhancing their quality of life and general well-being.

GROWING THE EVIDENCE IS TO BE WELCOMED - Physiotherapy as a profession is continuing to build the evidence base of the profession - studies along these lines are valuable in developing the understanding of how effective treatments are. The Chartered Society of Physiotherapy welcomes this work and supports the development of a stronger evidence base for physiotherapy practice.                    


On 23 September 2004, the CSP issued the following statement:

In response to the study on back pain and physiotherapy to be published in the BMJ, The Chartered Society of Physiotherapy (CSP) has issued the following statement:

'The findings of the study make no suggestion that physiotherapy doesn't work. The researchers have looked at two broad approaches to treating back pain and have found that one-off good quality physiotherapy advice is as effective for people with moderate levels of back pain as 'routine physiotherapy', a year after the interventions. However the patients receiving routine physiotherapy showed consistently bigger improvement in disability and general health and at 12 months had significantly less 'bodily pain'  than those receiving only advice.'

'What the study does suggest is that the CSP is right to be calling for the rapid roll out of patient self-referral schemes, which enable people to gain access to physiotherapy without having to see their GP first.

'A survey conducted by the CSP in 2003 revealed that nine out of ten people want to go direct to a physiotherapist for problems such as back pain, which shows that the public has a high level of confidence in the physiotherapy profession and would welcome the opportunity to access their services directly.

'We believe that expanding the number of self-referral schemes would enable the physiotherapy profession to fully exploit its skills in managing and preventing conditions such as back pain, would radically cut demands on overworked GPs and allow patients to take more control over their own care.'


For more information on innovative physiotherapy services, please call the CSP press office 020 7306 6616/6628/6163 or visit

The Chartered Society of Physiotherapy is the professional, educational and trade union body for the country's 43,000 chartered physiotherapists, physiotherapy students and assistants.  For previous media releases, visit:



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