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Abstract

Evidence for the effectiveness of physiotherapy for low back disorders is sparse. Recent trends recommend pain education and a focus on psychosocial rather than pathoanatomical factors. The Specific Treatment of Problems of the Spine (STOPS) trial is a recently published high quality randomized controlled trial of 300 participants receiving individualized physiotherapy or guideline-based advice. The results from pre-planned analyses of the STOPS trial challenge current trends in the management of low back disorders. This presentation will explore the results of the STOPS trial with reference to the current literature on the relative importance of pathoanatomical and psychosocial factors in clinical decision making and predicting future outcomes, selecting the right patient for the right treatment, mechanisms of effect in the STOPS approach, relative cost effectiveness for a more intensive treatment (individualized physiotherapy) compared to advice (which is generally considered to be a low cost and effective intervention), potential misinterpretations of the literature with a particular focus on manual therapy and motor control and rigorous assessment and clinical reasoning as critical components of effective treatment.

Biography

Email: j.ford@latrobe.edu.au