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Handout #5: Back Treatments and Devices: What Works and What Doesn 'tACTIVITY: Bed rest is NOT recommended as a treatment for simple LBP. In fact, studies show that bed rest for 2 -7 days is worse than ordinary activity and is not as effective as other treatments for relief of pain. Staying as active as possible without increasing pain is recommended. SPINAL MANIPULATION: Within the first 6 weeks of onset of pain, manipulation can provide short-term improvement in pain and activity levels. No studies have demonstrated what kind of manipulation works best nor which patients will benefit from this treatment. OTHER TREATMENTS: Ice, heat, massage, ultrasound and short-wave diathermy are used for symptom relief but have not been shown to have a significant effect on recovery. Traction, Transcutaneous Electrical Nerve Stimulation (TENS), shoe insoles and lifts, and lumbar corsets and supports have NOT been proven effective for LBP. The use of back belts has not consistently proven to decrease low back injury during manual handling job tasks. Back belt use in the workplace is currently being studied by the National Institute of Occupational Safety and Health (NIOSH). Magnets and other non-invasive pain treatments have not been documented to be effective in the treatment of low back pain nor have they been shown to be dangerous. Please inform your health care provider of any treatments you are using. Injections to trigger points, ligaments and facet joints have little to no evidence that support their use. Epidural steroid injection may be useful for LBP with sciatica but has significant risk associated. Acupuncture may improve movement and decrease pain for some patients but has not been shown effective for long-term LBP. Biofeedback has not been shown effective in acute LBP but may have some effect on chronic pain.
TREATMENTS THAT MAY BE HARMFUL:
Please inform your health care provider of any treatments you are using.
For information contact rtw_project@montana.edu, Dr. Patricia Butterfield, Montana State University-Bozeman. Do not copy without permission.
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