For Patients With Chronic Back Pain, Individualized Exercise a Successful Option
According to a recently published meta-analysis, physical therapy for chronic back pain that is tailored to a patient's individual needs has a greater likelihood of success compared to standard forms of treatment. The success rate was found to be 38% higher than patients who were treated with the standard form of treatment, which in this study, was defined as active or passive exercise.1 “Individualized” treatment was defined as including some aspects of personal coaching, where therapists, working with the patient, decide how the patient’s therapy should look.
The researchers conducted a meta-analysis of 58 randomized controlled trials of patients with chronic non-specific low back pain (n = 10,084). The trials used in the study examined individualized, personalized, and/or stratified exercise interventions that included psychological treatment or not.
The researchers examined the results at 12 weeks (short-term follow-up) to a 1 year (long-term follow-up). When looking at long-term follow-up, researchers found moderate evidence for pain intensity (-0.14 [-0.22 to -0.07]) and disability (-0.20 [-0.30 to -0.10]), indicating the effects of individualized treatment when compared with passive controls.
Overall, the researchers found that individualized exercise therapy for chronic low back pain was more effective when compared to standard treatment. Further, the researchers found that individualized therapy combined with cognitive behavioral therapy had a 84% higher success rate compared to standard treatment. Additionally, using a motor-control training seemed to be the most promising for individualized treatment.
It should be noted that most of the findings are based on low-to-moderate certainty of evidence. Still, individualized exercise had a relevant effect on pain intensity and disability in patients with chronic low back pain.
“The higher effort required for individual treatment is worthwhile because patients benefit to an extent that is clinically important,” says lead author Dr Johannes Fleckenstein from the Institute of Sport Sciences at Goethe University Frankfurt said in a press release.2
- Fleckenstein J, Floessel P, Engel T, et al. Individualized exercise in chronic non-specific low back pain: a systemic review with meta-analysis on the effects of exercise alone or in combination with psychological interventions on pain and disability. J Pain. 2022;23(11):1856-1873. doi:10.10116/j.pain.2022.07.055
- Treatment for back pain: 84 percent increase in success rate. News release. Goethe University; October 18, 2022. Accessed November 11, 2022. https://aktuelles.uni-frankfurt.de/englisch/treatment-for-back-pain-84-percent-increase-in-success-rate/