Physiotherapists' use of advice and exercise for the management of chronic low back pain: a national survey

The objective of the study was to establish the specific use of advice and exercise by physiotherapists, for the management of chronic low back pain (LBP). A questionnaire was mailed to a random sample of 600 members of the Irish Society of Chartered Physiotherapists. Open and closed questions were used to obtain information on treatments provided to chronic LBP patients. Respondents' treatment goals were also investigated, along with the typical methods used to assess treatment outcome. Four hundred and nineteen of the sample returned the questionnaire; 280/419 (67%) indicated that they currently treated LBP of which 76% (n=214) were senior grade therapists. Advice and exercise, respectively, were the treatments most frequently used for chronic LBP: advice was most commonly delivered as part of an exercise programme, with strengthening (including core stability) the most frequently used exercise type. Supervision of exercise and follow-up advice were underutilised with respect to the recommendations of relevant clinical guidelines. Pain relief was an important treatment goal. Emphasis on exercise programme supervision, incorporating reassurance that its safe to stay active and 'hurt does not mean harm', must be more effectively disseminated and promoted in practice. The influence of follow-up advice on exercise adherence warrants further investigation.