ABSTRACT

Physical therapies are widely used in the management of chronic pain, particularly a pain of musculoskeletal origin. Physical therapies can be primarily directed to modulation of the pain control system, such as with acupuncture. Or they can be primarily directed to movement of the pain-sensitive structures, either in a general manner, such as with exercise, or more specifically, as with manual treatments of mobilization and manipulation. Rest, either general, such as bed rest or local rest, such as with the case of lumbar supports, can be considered as physical therapies. There have been randomized controlled studies of these therapies but their quality has tended to be poor and so systematic reviews have provided only limited support for their use.