A Challenging Area to Study

Scientific studies of treatment interventions for musculoskeletal problems such as low back pain are often challenging to conduct. The “scientific experiment”, where only one variable at a time is changed while all others are controlled, is often ill suited:

  • The methods for finding and defining the underlying problem(s) or deviation(s) are not well specified.
  • The problem usually involves a whole mechanical system where the problem is not limited to just a single muscle, joint or other component.
  • The problem is often related to the coordination between different components.
  • As the underlying problem tends to be complex and involve many variables so follows the intervention. One single intervention in a single component of the problem is seldom effective.
  • Except for drug treatments, placebo treatment is difficult or impossible to find.

Despite these challenges, the “gold standard” for any treatment evaluation is the prospective “randomized controlled study”, mainly because there are few alternatives.