Physical Therapy

Health care is changing rapidly.The clinical professional roles are evolving, new networks are being established, costs are decreasing, and the transfer of knowledge is quicker.Outcome studies and randomized controlled trials (RCTs) are becoming the gold standard for efficacy of treatment.What was accepted treatment yesterday may not be reimbursed tomorrow.The physical therapy profession and their treatment methods for low back pain (LBP) are being increasingly ~c r u t i n i z e d .~, ' ~, ~~ Approximately one third of all physical therapy treatment focus on back pain or back-pain-related symptomatology.The physical therapist is widely considered an important member of the team treating patients who have back ailments.However, the treatment methods of physical therapists are changing.An active, goal-oriented and evidence-based treatment regimen is being promoted.This change has occurred predominantly through four venues: (1) more physical therapists are involved in clinical research, (2) the competition for patients from other health care providers is increasing, (3) large networks of physical therapy clinics are protocol driven and collect outcome data, and (4) reimbursement for treatment is changing.This article focuses on exercises and modalities commonly used as physical therapy treatment for the patients who have nonspecific low back pain.4,39,42We will discuss the guidelines that have prompted change and the evidence for using exercises or modalities as treatment for patients who have the above symptomatology.