Advances in physiotherapy for chronic low-back pain: a level I systematic review.
Filippo Migliorini, Nicola Maffuli, Luise Schäfer et al.
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In 30 seconds
This level I systematic review qualitatively examined randomised controlled trials of physiotherapy programmes for chronic low-back pain (cLBP), identified through searches of PubMed, Web of Science and Embase in August 2025. It included 150 trials involving 12,773 patients. Mean symptom duration was 61.2 ± 51.0 months, and mean follow-up was 4.3 ± 5.9 months. The review reports that individual studies support particular interventions, but concludes that many management strategies share common elements; combining elements may be useful, although the findings do not establish a decisive treatment approach.
Key findings
- The review included 150 randomised controlled trials with 12,773 patients.
- Mean symptom duration was 61.2 ± 51.0 months; mean follow-up was 4.3 ± 5.9 months.
- The authors found that many cLBP management strategies share common elements, while individual trials highlight specific interventions.
Why it matters
The review brings together a large body of trial evidence on physiotherapy for chronic low-back pain, a condition for which the abstract notes that internationally accepted treatment algorithms are lacking. Its synthesis points to shared components across approaches and supports further investigation of integrated, multidisciplinary management, while stopping short of identifying a definitive programme.
What to keep in mind
The review’s qualitative synthesis does not establish a decisive treatment approach. Mean follow-up was 4.3 ± 5.9 months, limiting the duration of outcomes represented.