A prospective controlled study of the effect of the Swedish Back School in chronic idiopathic Low Back Pain was conducted. Forty-eight patients entered the study. There were no significant pre-treatment differences between the experimental group members who attended the four lessons of the Back School, and the control group who received four detuned shortwave applications to the low back. Forty-three patients (21 in the experimental and 22 in the control group) completed the study. Subjects were repeatedly tested for one year. The following assessments were made: 1) subjective scores of pain and functional capacity, and 2) objective measurements of spinal mobility. After one year, no statistically significant differences between the two groups were observed. Given the proven efficacy of the Back School in (sub)acute Low Back Pain, it should be administered when it is most beneficial, i.e. in the early phase of Low Back Pain.
During a three-year follow-up study of 31 chronic idiopathic low back pain patients significant spontaneous improvements of pain and disability scores were found, while range of motion of the lumbar spine decreased. It is argued that increasing stiffness of the low back may be the clinical manifestation of the process of stabilization, that takes place in previously painful instable motion segments. The present findings have also implications for the interpretation of changes of spinal motion. Restriction of range of motion seems to be a normal long-term development in low back pain patients and is accompanied by a diminution of pain and disability.
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