2008-10-24 / Columnists

Eye On Physical Therapy

Commentary By Dr. Tim Rohrs, DPT

When patients visit a health care practitioner, they would like some assurance that the treatment offered will help their condition. Each year people spend millions of dollars on treatments, herbs, supplements and devices seen on infomercials that have NOT had their efficacy tested in randomized controlled, blind studies. Health care professionals have a responsibility to recommend treatments that have been subjected to rigorous studies and that have shown a significant difference compared to other treatments.

Neck pain is one of the top 10 reasons for a patient to visit a doctor. The lead article in the most recent issue of Spine reports on the results of a randomized clinical trial which demonstrated that patients who received manual physical therapy and exercise had twice the improvement in symptoms compared to the current guideline group.

The subjects in the study experienced both short and long term improvements in their neck pain. The study compared the use of manual therapy and exercise compared to the current guidelines of advice, rest, and range of motion.

The results of this study are comparable to those reported by Hoving et al. in 2002, which also demonstrated that manual physical therapy and exercise resulted in excellent clinical results in the treatment of neck pain while also providing a significant cost savings compared to usual physician care (Kothals-de Bos et al. 2003).

Manual physical therapy includes the use of hands-on techniques including joint and soft-tissue mobilization, designed to restore motion and reduce pain. Hurwitz et al. (2008) concluded in a systematic review on neck pain, also in the journal Spine, "Our best evidence synthesis suggests that therapies involving manual therapy and exercise are more effective than alternative strategies for patients with neck pain."

Tim Flynn, PT, PhD, president of the American Academy of Orthopaedic Manual Physical Therapy, expressed confidence that, "This study broadens the base and depth of evidence that manual physical therapy is the first line treatment for patients suffering from neck and arm pain." He continued, "Year after year the physical therapy profession continues to produce high quality randomized, controlled trials that demonstrate conclusively that our profession provides better outcomes for less money, while also being substantially safer than other medical interventions.

"Wake up America, to a new day without pain." If you have neck or back pain or the aches and pains of musculoskeletal problems contact your physician for a referral to a physical therapist."

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