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The McKenzie protocol also now includes flexion protocols and stresses the importance of differentiating whether flexion or extension improves patient's symptoms. As a result, McKenzie principles are used by many physical therapists in the treatment of low back pain, whereas Williams Exercises are no longer taught as a physical therapy protocol.
There is only weak evidence for the effectiveness of the method's use for treating lower back pain. [8] A 2019 systematic review found that there was evidence that it could reduce chronic lower back pain in the short term, and enhance function in the longer term, but that most studies of the treatment had methodological flaws, such as small sample sizes and a lack of blinding.
Opioid treatment for chronic low back pain increases the risk for lifetime illicit drug use [101] and the effect of long-term use of opioids for lower back pain is unknown. [102] For older people with chronic pain, opioids may be used in those for whom NSAIDs present too great a risk, including those with diabetes, stomach or heart problems.
The best treatment for back pain will depend on what’s causing it and how severe the pain is. The good news is most people’s back pain improves in six weeks, and yours may even go away on its own.
A few low-quality studies have suggested that the activator may be as effective as manual adjustment in treatment of back pain. [20] A single high-quality study has suggested that activator-assisted manipulation directed by leg-length testing was significantly inferior to manual spinal manipulation guided by palpation and was more similar to ...
The most commonly recommended treatment for long-lasting pain in the lower back are exercises and fitness training usually under the supervision of a qualified clinician. This treatment does help the vast majority of back pain patients but does not have a pain-relieving effect on Modic changes or pain from Modic changes. [52]
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