I have heard of PTs who are adamant about ultra-sounding patients with acute & chronic low back pain (LBP). Do some just wish to ignore conclusions by the Cochrane review board?

“The evidence from this systematic review is uncertain regarding the effect of therapeutic ultrasound on pain in individuals with chronic non-specific LBP. 

 Whilst there is some evidence that therapeutic ultrasound may have a small effect on improving low back function in the short term compared to placebo, the certainty of evidence is very low. The current evidence does not support the use of therapeutic ultrasound in the management of chronic LBP. – Ebadi et al 2020

Even if let’s say passive modalities are effective, BUT…

“Passive coping is a strong and independent predictor of disabling neck and/or back pain.” – Mercado et al 2005

“Patients who report passive coping strategies experience a significant increase in the risk of persistent symptoms.” – Jones et al 2006

There is limited evidence for using passive modalities yet on the other hand there is growing evidence that passive coping strategies and reduced self-efficacy are strong risk factors for the maintenance of chronic pain… so why are university programs still insisting on teaching modalities in PT schools?

References: 1. Ebadi S, et al Therapeutic ultrasound for chronic low back pain. Cochrane Database Syst Rev. 2020 Jul 5;7(7):CD009169.

  1. Mercado AC, et al Passive coping is a risk factor for disabling neck or low back pain. Pain. 2005 Sep;117(1-2):51-7.
  2. Jones GT et al Predicting persistent disabling low back pain in general practice: a prospective cohort study. Br J Gen Pract. 2006 May;56(526):334-41.
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