People who experience back pain with sciatica may find it to be beneficial to start physical therapy right away. According to new research in Annals of Internal Medicine, this new advice goes against what doctors usually advise patients with back pain to do.
Normally, when people have back pain, they are told to remain active and give their symptoms time to heal before seeking any treatment, such as physical therapy. However, this new research suggests that those who have sciatica, meaning their pain radiates into their leg, should start physical therapy as soon as possible
Not Everyone Will Need Therapy
Most people will experience back pain at some time in their lives. Studies show that about 30 percent of those episodes include sciatica, so it is important to look at this type of pain individually from other types of back pain. While not everyone will need therapy to deal with back pain, those with sciatica seem to find an ease of symptoms and prolonged episodes of pain when they receive physical therapy. This is what led researchers to look into the benefits of physical therapy for those with sciatica.
For the clinical trial, 220 patients aged between 18 and 60 years old with back pain and sciatica where examined. Each patient had back pain that had begun within the previous 90 days. On average, participants had been experiencing back pain for 35 days.
The participants were randomly assigned to two treatment groups—one with physical therapy, and the other with no therapy. Those in the physical therapy group received an active form of therapy for four weeks, which included exercises and manual techniques such as hands-on spinal mobilization, tailoring the treatment’s specifics to individual patients. Patients in the second group received no therapy but were advised to remain active.
Patients were required to report on their level of pain and its impact on their lives at the four-week mark, then again at six months, and after one year. At each point of checking in, patients who had completed physical therapy reported less disability than patients who had no therapy. These differences were large enough to be considered meaningful at the early-outcome time point, suggesting real benefits for patients.
It is unknown which components of the physical therapy program contributed most to the patients’ response to the treatments, or if the different levels of provider contact experienced by each patient could be a factor in the outcomes. Researchers note that this study helps underline the importance of patients seeking treatment options at the first sciatica sign. The next critical step in this research will be to integrate the findings into clinical practice.