Almost everyone has lower back pain at some time in their lives, and in some people, it can be debilitating. For most causes of back pain, surgery—though often performed—probably doesn't do any good, and other therapies have little or no evidence backing them up. Pretty much the only advice everyone agrees on is to stay active. Many doctors also recommend physical therapy, but that may not help either, according to a new study from the United Kingdom.

What the researchers wanted to know: Is getting physical therapy for lower back pain better than having just one session where the physical therapist gives you advice?

What they did: Two hundred eighty-six patients who'd had lower back pain for at least six weeks (and didn't have serious health problems) were randomly assigned either to get advice and have physical therapy or just to get advice. Everyone also had one session when a physical therapist examined them and told them to stay active. The physical therapy group got up to five more sessions with a physical therapist.

What they found: After a year, patients who'd had physical therapy were objectively no better off than patients who'd only gotten advice. They hadn't improved more on any measures—disability, physical function, bodily pain, or anything else the researchers measured. Interestingly, though, patients who'd had physical therapy were more likely to think they were better off after treatment. Since many doctors think psychological factors are very important in back pain, that perception could actually be helpful.

What the study means to you: Physical therapy may help some people. Everyone in the study met with a physical therapist at least once, and got advice from them. But overall, the advice is the same: Stay active.

Caveats: Physical therapists in this study used procedures that are standard for the U.K.'s National Health Service; physical therapy probably varies from place to place. Nearly a third of patients failed to fill out the study's questionnaire at the end of the year, so the researchers didn't get all the data they wanted.

Find out more: Information and advice on lower back pain from the National Library of Medicine.

Read the article: Frost, H., et al. "Randomised Controlled Trial of Physiotherapy Compared With Advice for Low Back Pain." British Medical Journal. September 25, 2004, Vol. 329, pp. 708-711.

Article online: http://bmj.bmjjournals.com