Low back pain remains one of the most common symptoms seen by both physicians and Physical Therapists. Physical Therapy remains the gold standard for the conservative treatment of low back pain due to its’ clinical effectiveness and cost savings vs. other forms of treatment including usual care. In our Boulder Physical Therapy practice we consistently follow the research and best practices for the treatment of this condition to ensure patients achieve optimal outcomes in fewer visits. Thankfully there is no shortage of evidence on low back pain to help guide our clinical practice. Recently the clinical practice guidelines were updated on the management of this condition which help guide clinicians on the most effective treatments for low back pain.
George and colleagues published the evidence summary on the evaluation and treatment in the Journal of Orthopedics and Sports Physical Therapy (2021). Authors found the highest levels of evidence for the utilization of exercise in patients with acute (Grade B) and chronic (Grade A) low back pain. In addition, Grade A evidence was found to support the utilization of spinal manipulation or mobilization for the treatment of acute or chronic low back pain. Trigger point dry needling came in at a Grade C due in part to its’ relatively recent implementation in Physical Therapy practice and our clinical research. This article supports the utilization of hands on interventions in the short term before transitioning to high level strength training exercises in order to create long term results and recoveries in patients with low back pain.