Early physiotherapy intervention in an Accident and Emergency Department reduces pain and improves satisfaction for patients with acute low back pain: a randomised trial.

QUESTION What is the effect of early physiotherapy intervention on pain and patient satisfaction in acute low back pain? DESIGN Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis. PARTICIPANTS 110 patients attending the Accident and Emergency Department of a local acute hospital. INTERVENTION The experimental group received early physiotherapy intervention which consisted of education, reassurance, pain management, mobility training, interferential therapy, walking training, and walking aids as indicated. The control group received only walking training and walking aids as indicated. All participants received conventional medical intervention and outpatient physiotherapy intervention. OUTCOME MEASURES Pain was measured using the Numeric Pain Rating Scale and satisfaction was measured using the Numeric Global Rating of Change Scale at baseline, discharge from the Accident and Emergency Department, admission to the Physiotherapy Outpatient Department, 1 month, 3 months, and 6 months. RESULTS Participants in the experimental group had 1.6 out of 10 points (97.5% CI 0.8 to 2.3) less pain than the control group on discharge from the Accident and Emergency Department and still had 0.9 points (97.5% CI 0.1 to 1.6) less pain on admission to the Physiotherapy Outpatient Department. Participants in the experimental group were 2.1 out of 20 points (97.5% CI 1.2 to 2.9) more satisfied than the control group on discharge from the Accident and Emergency Department. CONCLUSION Early physiotherapy intervention was effective in reducing pain and increasing satisfaction for patients with acute low back pain in an Accident and Emergency Department but the effect tailed off.