Q: I went on-line and saw there are international guidelines recommending physiotherapy treatment for chronic back pain suffers. What can this kind of treatment do for me?

A: Back pain is costly and disabling around the world. Billions of dollars are spent on back care in the United States and in other industrialized countries. Many studies are under way to try and find the most effective, least costly treatment for this problem.

The international guidelines proposed come from England. They are based on population studies from Europe. The emphasis is on pain management using exercise and advice. Spinal manipulation has been shown helpful in the early phases of back injury. It may not be so helpful for chronic problems.

Different therapists taking various approaches to the problem of chronic low back pain. They help patients pace their activities with the goal in mind of returning to usual activity and work. Stabilization exercises for the trunk and abdomen may be helpful in reducing pain and disability for chronic low back pain sufferers.

With decreased disability and improved activity, physiotherapy helps improve patients' quality of life. Physiotherapy has been shown to decrease the total dollars spent on back care. Both you and your pocketbook feel better.

Duncan J. Critchley, MSc, et al. Effectiveness and Cost-Effectiveness of Three Types of Physiotherapy Used to Reduce Chronic Low Back Pain Disability. In Spine. June 15, 2007. Vol. 32. No. 14. Pp. 1474-1481.