Mission Statement

Rock Valley Physical Therapy is dedicated to making better lives by fostering a timely, optimal outcome in a customer focused environment. Our highly skilled and compassionate team provides individualized one-on-one care for each patient. Our patients typically work with one therapist from start to finish. Every team member goes through extensive training and mentorship to ensure that each patient receives the highest level of care. At Rock Valley everything we have and everything we learn is about making better lives, one patient at a time.



We look forward to working with you!



- Amy, Luke, and Rachael



Disclaimer: This blog is intended for informational purposes only and is not to be considered medical advice. It is not intended to replace consultation with a licensed medical profession or qualify as physical therapy treatment. We are under no circumstance liable for advice given on this website.



Monday, April 4, 2011

Low Back Pain

 
 
There is no question that low back pain is a problem for many people.  Annually, low back pain accounts for approximately 40% of all lost workdays and has been estimated to cost $49 billion within the industrial sector.1



So what do we do about it?
Attempts to identify effective interventions for patients with low back pain (LBP) have been largely unsuccessful.2,3  One explanation offered for the lack of evidence is the inability to define subgroups of patients most likely to respond to a particular intervention.4  Recently, Flynn et al. validated a clinical prediction rule that identifies a subgroup of patients with nonspecific low back who are likely to respond to spinal manipulation.5


The predictor variables, based on the history and physical examination, were identified as follows:
  • Pain of less than 16 days duration
  • No symptoms distal to the knee
  • One or both hips with internal rotation < 35°
  • One or more hypomobile lumbar segments
  • FABQ*-work subscale score of < 19
The presence of four out of five variables in the prediction rule increases the likelihood of success with manipulation from 45% to 95%.

According to a study by Childs et al.6, patients who were “positive on the rule” (met 4 or 5 of 5 predictor variables) and did not receive spinal manipulation were 8 times more likely to experience a worsening in disability as compared to those that did. 


*Fear-Avoidance Belief Questionnaire: measure of how beliefs of fear and avoidance are contributing to function.


References:
Leigh J et al.  Occupational injury and illness in the United States.  Arch Int Med 1997;157:1557-1568.
van Tulder MW, Koes BW, Bouter LM. Conservative treatment of acute and chronic nonspecific low back pain: a systematic review of randomized controlled trials of the most common interventions. Spine 1997;22:2128–56.
van Tulder MW, Malmivaara A, Esmail R, et al. Exercise therapy for low back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine 2000;25:2784–96.
Bouter LM, van Tulder MW, Koes BW. Methodologic issues in low back pain research in primary care. Spine 1998;23:2014–20.
Flynn T, Fritz J, Whitman J, et al.  A clinical prediction rule for classifying patients with low back pain who demonstrate short-term improvement with spinal manipulation.  Spine 2002;27:2835-2843.
Childs J, Flynn T, Fritz J.  A perspective for considering the risks and benefits of spinal manipulation in patients with low back pain.  Man Ther 2006;11:316-320.
Ernst E, Canter P.  A systematic review of systematic reviews of spinal manipulation.  J R Soc Med 2006;99:192–196.
Flynn T, Fritz J, Whitman J, et al.  A clinical prediction rule for classifying patients with low back pain who demonstrate short-term improvement with spinal manipulation.  Spine 2002;27:2835-2843.
UK BEAM trial team.  United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care.  BMJ 2004.10:1-8.


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