Status of weight reduction as an intervention in physical therapy management of low back pain: Systematic review and implications

Abstract

Obesity is an independent predictor of back pain and its severity, and healthy weight is associated with less pain and disability, and greater capacity to be active. Given the commitment of physical therapy to health-focused practice, we systematically reviewed current literature on physical therapy management of low back pain with special attention to body weight and its management. Relevant MeSH headings for physical therapy, low back pain and management were used to identify articles in the EMBASE database. The search was limited to randomized controlled trials and published in English over 1 year (June 2011 through May 2012). Of 53 articles meeting criteria, 35 source articles were analyzed. Of these, 17 included initial weight measurement; six included post-intervention weight measurement; five compared weights pre–post-intervention; 18 articles did not include weight as an outcome measure; and none included weight management as either a primary or secondary low back pain intervention. Although the relationship between back pain and overweight has not been established to be causal, this should not exclude its being a focus of contemporary physical therapy practice guidelines. This practice augments patient health consistent with the profession's commitment to the ICF and health-focused practice, and minimizes weight-related contribution to back pain.

Key words::

• Health
• low back pain
• physical therapy
• weight management

Acknowledgement

The authors thank Charlotte Beck, biomedical librarian, for her assistance.

Conflict of interest. None declared.