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How much longer should I wait before saying something after one week of treatment with no results?

Q: I'm seeing a physiotherapist for low back pain and sciatica. Part of the treatment includes traction on a table for 20 minutes. It's been a week of treatments and so far I'm not seeing any results. How much longer should I wait before saying something?

A: Your therapist should be asking you each time he or she sees you how you are doing (better, same, or worse). This information is used to progress or alter your treatment program. Let your therapist know right away what's happening (or not happening) with you.

Research on traction has not shown it to be a reliable and effective form of treatment for low back pain (LBP). A recent review of the traction studies showed the fault may lie with research methods rather than the traction. More studies are needed to find out which patients (if any) get the best results with traction.

Based on clinical practice (what seems to work) rather than evidence-based practice (what has been proven effective) traction should have a lasting effect within the first four weeks.

Annette Agnes Harte, BSc, et al. Current Use of Lumbar Traction in the Management of Low Back Pain: Results of a Survey of Physiotherapists in the United Kingdom. In Archive of Physical Medicine and Rehabilitation. June 2005. Vol. 86. No. 6. Pp. 1164-1169.

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