Passive modalities, such as massage, appear to help with low back pain but much of this can be explained by regression to the mean, says Dr Michael Vagg
A large percentage of patient presenting with lower back pain get better without treatment over 8-12 weeks, says Dr Michael Vagg, a pain specialist and a clinical senior lecturer in musculoskeletal medicine at Deakin University School of Medicine.
Passive modalities, such as massage, appear to help with symptoms but much of this can be explained by regression to the mean, he says.
âPeople like those things and still use them because the phenomenon of regression to the mean explains a lot of the apparent success,” says Dr Vagg.
“If you have long-term back pain, for example, you are more likely to try something new at the time when that pain has been getting worse for a little while, which is statistically also the time when it should be starting to get better because it will always vary around its long-term average.â
Therapies where the patient is actively involved in active management of lower back pain tend to produce better outcomes than passive modalities, says Dr Vagg.
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