Evidence Review

Physical Therapies

Manipulation

Back exercises

Physical Agents and Modalities

Traction

Transcutaneous Electrical Nerve Stimulation (TENS)

Shoe Insoles and Shoe Lifts

Lumbar Corsets and Supports

Trigger Point and Ligamentous Injections

Acupuncture

Epidural Steroid Injections

Facet Joint Injections

Biofeedback

Group education: back school

Back exercises

There are now 28 RCTs of specific back exercises for low back pain, but many are of poor quality. A number of trials are reported to be in progress that may change this within the next few years.

	On the evidence available at present, it is doubtful that specific back exercises produce clinically significant improvement in acute low back pain, or that it is possible to select which patients will respond to which exercises.
	There is some evidence that exercise programmes and physical reconditioning can improve pain and functional levels in patients with chronic low back pain. Evans & Richards 1996, van Tulder et al 1996b
	There are theoretical arguments for commencing exercise programmes and physical reconditioning at around 6 weeks. AHCPR 1994, CSAG 1994