Physical Therapy Intervention for Chronic Soft Tissue Injury in the Low Back: A Systematic Review

Abstract

The objective of this systematic review was to assess the effectiveness of physical therapy interventions for chronic soft tissue injury to the low back. Only randomized controlled trials identifying physical therapy interventions within the scope of practice for Canadian physiotherapists and athletic therapists, with a clinical diagnosis of chronic soft tissue injury to the low back with symptoms lasting a minimum of three months were included. Only three studies of the 87 articles reviewed were deemed eligible for review based on the relevancy criteria set forth by the reviewers. Percutaneous electrical nerve stimulation (PENS) and therapist supervised active exercise programs may be a promising treatment modality for chronic low back pain (CLBP) by reducing pain, improving self-reported disability, and improving physical performance. The consensus amongst reviewers’ was that the quality of the three articles were deemed of weak methodological quality making author inferences to the success of the reported physical interventions towards the modulation of pain, improved range of motion or patient satisfaction inconclusive. At the most basic level, there is a lack of uniformity in defiing low back pain based on time, with defiitions ranging anywhere from one week to six months. This is a major limitation in existing scientifi literature. The ability to compare studies and results is hampered by the disparities in CLBP defiition. The scientifi rigor applied to studies devoted to therapeutic interventions and rehabilitation is poor.

Keywords Physical therapy intervention, chronic soft tissue injury, low back