Physio-patient relationship is key to back pain relief

The way that a physiotherapist interacts with their patient could be nearly as important as the treatment itself for people with back pain, suggests a new study from Canada.

Scientists studied 117 people who had chronic lower back pain, splitting the volunteers into four groups:

Group 1 interacted with the physiotherapist for five minutes before electrotherapy

Group 2 spent 30 minutes with the physiotherapist during electrotherapy with strong verbal and non-verbal communication throughout

Group 3 received five minutes of interaction and pretend electrotherapy (they did not realise the machine was off)

Group 4 received lengthy interaction and pretend electrotherapy.

Before and after treatment the volunteers rated the intensity of their pain on a 10-point scale.

Those who had enhanced interaction with the physiotherapist and real electrotherapy reported an average of a three-point reduction in pain intensity and an improved pain threshold.

The group with the next greatest improvement in pain was people who received enhanced interaction and pretend electrotherapy.

Smallest improvements were seen in volunteers who had pretend treatment and limited interaction with the physiotherapist.

The way physiotherapists treat patients at present “is not the best approach,” suggests Dr Jorge Fuentes who led the research. “That might be the reason physical therapy interventions have such a modest effect for patients with chronic conditions.

“The therapeutic context in which the interventions are delivered matters. We have to take these non-specific factors into consideration.”