Clinical effects of early physiotherapy education for acute non-specific low back pain in the emergency department. A randomized controlled trial

BACKGROUND: Education and encouragement to remain active are considered first-line treatments for acute non-specific low back pain (NSLBP). Aim: to assess the effectiveness of an early physiotherapy education intervention - including also a posture exercise - combined with standard medical care, compared to standard medical care alone, in patients presenting with acute NSLBP in the emergency department (ED).METHODS: Adults with acute NSLBP were randomized to receive either standard care plus a physiotherapy session involving education, reassurance, pain neuroscience, and a guided lumbar exercise or standard medical care. Participants were assessed at three timepoints: before treatment (baseline), at 1 month, and at 3 months post-treatment. Outcome measures included the 0-10 Numerical Rating Scale (NRS), the Roland-Morris Disability Questionnaire (RMDQ), and the 5-level EuroQol-5D (EQ-5D-5L) for assessing quality of life (QoL). Linear mixed model analyses for repeated measures were performed for each outcome (P<0.01).RESULTS: Significant time effects were observed for NRS, RMDQ, and EQ-5D-5L (P<0.001) in both groups across all timepoints. No significant group effects or time-by-group interactions were found at any timepoint.CONCLUSIONS: An early, single-session physiotherapy education program added to standard ED care resulted in equal clinical outcomes compared to standard care alone in patients with acute NSLBP. Future studies should investigate more structured models of care to improve outcomes in this population.