Recent trials suggest that adequate reassurance and advice coupled with the early resumption of normal activity may be more effective than physiotherapy interventions. Bed rest appears to have a deleterious effect on recovery and return to work. The evidence on the effectiveness of manipulation and conventional physiotherapy for patients with chronic LBP is conflicting. Some evidence suggests that manipulation and conventional physiotherapy may offer comparable long-term therapeutic benefits, compared to placebo groups. Limited evidence suggests that physical reconditioning can improve chronic LBP sufferers' levels of functioning and pain report.
Back school appears to have little useful effect on knowledge or pain perception and disability.
The effectiveness of operant conditioning and cognitive therapy is uncertain in relieving either pain or disability. Multidisciplinary treatment has been insufficiently evaluated. Author's conclusions Research to date has been insufficiently rigorous to give clear indications of the value of treatment for non-specific low back pain patients. No treatment has been shown beyond doubt to be effective. Where there is reasonable evidence to suggest that an intervention is effective, issues including the most optimal timing and duration of treatment need to be explored.