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Management of Work-Related Low Back Pain: A Population-Based Survey of Physical Therapists

S Poitras, PT, PhD, is Research Fellow, Groupe de Recherche Interdisciplinaire en Santé, Université de Montréal, CP 6128, Succursale Centre-ville, Montreal, Quebec, Canada H3C 3J7 (stephane.poitras{at}mcgill.ca)
R Blais, PhD, is Full Professor, Groupe de Recherche Interdisciplinaire en Santé, Université de Montréal
B Swaine, PT, PhD, is Associate Professor, École de Réadaptation, Université de Montréal, and Researcher, Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montreal, Quebec, Canada
M Rossignol, MD, is Associate Professor, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, and Researcher, Department of Public Health of Montreal, Montreal, Quebec, Canada

Address all correspondence to Dr Poitras

Background and Purpose. Physical therapy often is used in the management of work-related low back pain (LBP). Little information, however, is known about the types of interventions used by physical therapists in the management of this condition. The objective of this study was to describe the interventions used by physical therapists in the treatment of workers with acute or subacute LBP, with or without radiating pain below the knee. Subjects. Clinical management questionnaires for workers without and with radiating pain were returned by 190 and 139 physical therapists, respectively. Methods. For each treatment session, therapists recorded treatment objectives, interventions, and education provided to 2 workers with LBP, 1 with radiating pain and 1 without radiating pain. Results. The majority of physical therapists used stretching and strengthening exercises, spinal mobilizations, soft tissue mobilizations and massage, manual traction, posture correction, interferential current, ultrasound, heat, and functional activities education. With radiating pain, the majority of the therapists also used cold and the McKenzie approach. Treatment objectives pursued by the majority of the therapists were decrease of pain, increase of range of motion, increase of muscle strength (force-generating capacity of muscle), decrease of muscle tension, and worker education. Discussion and Conclusion. Physical therapists use an array of interventions with workers with LBP. The effectiveness of most interventions reported has not been well studied.

Key Words: Back pain • Health services research • Occupational health • Physical therapy • Practice patterns