THE EFFECT OF HYDROTHERAPY ON PEOPLE WITH NON-SPECIFIC CHRONIC LOW BACK PAIN

Back pain has become a widespread issue that significantly affects many aspects of the lives of those afflicted. Hydrotherapy has gained attention in the medical and sports communities and has been recognized as a valuable treatment method. The aim of the current research was to determine the effect of hydrotherapy on pain intensity and balance in people with non-specific chronic back pain.

For this systematic review, Persian and English articles were searched for between 2014 and 2024 in Google Scholar, Scopus, PubMed, SID, ISC, and Magiran databases. Finally, 21 relevant articles were selected based on the inclusion and exclusion criteria. The effect of hydrotherapy on pain intensity and balance in people with chronic non-specific low back pain was investigated.
The results of 2 studies showed that hydrotherapy and the Williams flexion model significantly reduced pain and increased dynamic balance. Three studies suggested that hydrotherapy exercises have positive effects on reducing pain and improving balance in people with chronic non-specific low back pain. One study indicated that hydrotherapy does not affect the electrical activity of the back muscles and that the improvement of pain depends on other factors. In addition, the results of 4 studies showed that hydrotherapy exercises and massage therapy help reduce pain, where 6 studies showed that specific movements in water and strengthening the core muscles are also beneficial.
The authors concluded that, based on the studies reviewed in the present research on hydrotherapy, this method can be considered one of the effective approaches for reducing pain intensity and improving balance in individuals with non-specific chronic back pain.

Great, yet another method that is effective for back pain!

The evidence is as good as for many other approaches.

Hold on, there are many caveats!!!

• Due to the nature of the treatment, most primary studies do not control for placebo effects (JUST LIKE STUDIES OF CHIROPRACTIC, FOR INSTANCE).
• The treatment is not a uniform modality but includes several different therapies which makes it impossible to say what actually works and what not (JUST LIKE STUDIES OF CHIROPRACTIC, FOR INSTANCE).
• The primary studies are burdened with many more methodological flaws (JUST LIKE STUDIES OF CHIROPRACTIC, FOR INSTANCE).
• The research is done mostly by investigators who want to show that their treatment works (JUST LIKE STUDIES OF CHIROPRACTIC, FOR INSTANCE).
• The effect sizes tend to be small (JUST LIKE STUDIES OF CHIROPRACTIC, FOR INSTANCE).

I could continue, but you probably get the drift.

So, if you have back pain, should you see a chiropractor (osteopath, acupuncturist, homeopath, other SCAM practitioner who claims his/her therapy works for sore backs) or a practitioner of hydrotherapy?

A difficult choice?

Let me help you:

• the evidence is flimsy for all;
• the costs for chiro etc. tend to be high;
• the risks of chiro etc. can be considerable;

Best to choose a treatment that is inexpensive and low-risk … which means?

Yes, you got it: you might as well choose hydrotherapy!