A Randomized, Placebo-Controlled Trial of Exercise Therapy in Patients with Acute Low Back Pain

TLDR

The study aimed to evaluate whether exercise therapy improves outcomes for patients with acute low back pain. In a multicenter randomized trial, 40 Dutch general practices enrolled patients who were assigned to exercise instruction with daily life advice, placebo ultrasound, or usual care, all receiving analgesics and low back pain education. Among 473 participants, exercise therapy did not reduce recurrence rates, improve functional health, or lower medical care use compared with usual care or placebo, and was ultimately found to offer no advantage over standard general practitioner care.

Abstract

To assess the efficacy of exercise therapy for acute low back pain, a randomized, placebo-controlled trial was performed in 40 Dutch general practices. Patients received either exercise instruction with advice for daily life by a physiotherapist; placebo ultrasound therapy by a physiotherapist; or usual care by the general practitioner. All patients received analgesic agents and information on low back pain before randomization. Four hundred seventy-three patients were included. No differences in number of recurrences, functional health status, or medical care usage could be found among the three groups. In the exercise group, duration of recurrences was shorter and patients were less tired during the first 3 months than in the usual care group, but no differences were found between the exercise and placebo groups. It was concluded that exercise therapy for patients with acute low back pain has no advantage over usual care from the general practitioner.