{"id":982,"date":"2024-07-19T18:01:20","date_gmt":"2024-07-19T17:01:20","guid":{"rendered":"https:\/\/www.forethoughtmed.com\/?p=982"},"modified":"2024-09-10T10:37:19","modified_gmt":"2024-09-10T09:37:19","slug":"how-physiotherapists-distinguish-acute-vs-chronic-low-back-pain-for-tailored-treatment","status":"publish","type":"post","link":"http:\/\/www.forethoughtmed.com\/pt\/how-physiotherapists-distinguish-acute-vs-chronic-low-back-pain-for-tailored-treatment\/","title":{"rendered":"Como os fisioterapeutas distinguem a dor lombar aguda da cr\u00f3nica para um tratamento personalizado"},"content":{"rendered":"<p>Low back pain is a common foe, but its duration \u2013 acute or chronic \u2013 plays a crucial role in determining the most effective physiotherapy (PT) approach. Here&#8217;s how physiotherapists decipher the difference and craft personalized treatment plans.<\/p><figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"1117\" height=\"800\" src=\"http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/08\/forethought-blog-34-1117x800.jpg\" alt=\"Infografia sobre o ajustamento quiropr\u00e1tico da escoliose: explorar os benef\u00edcios e os riscos dos cuidados quiropr\u00e1ticos para os doentes com escoliose.\" class=\"wp-image-2262\" srcset=\"http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/08\/forethought-blog-34-1117x800.jpg 1117w, http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/08\/forethought-blog-34-558x400.jpg 558w, http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/08\/forethought-blog-34-768x550.jpg 768w, http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/08\/forethought-blog-34-1000x716.jpg 1000w, http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/08\/forethought-blog-34.jpg 1280w\" sizes=\"(max-width: 1117px) 100vw, 1117px\" \/><\/figure><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_74 counter-hierarchy ez-toc-counter ez-toc-light-blue ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">\u00cdndice<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Alternar o \u00edndice\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Alternar<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1' ><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"http:\/\/www.forethoughtmed.com\/pt\/how-physiotherapists-distinguish-acute-vs-chronic-low-back-pain-for-tailored-treatment\/#The_Timekeeper_Unveiling_the_Duration_of_Discomfort\" >The Timekeeper: Unveiling the Duration of Discomfort<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"http:\/\/www.forethoughtmed.com\/pt\/how-physiotherapists-distinguish-acute-vs-chronic-low-back-pain-for-tailored-treatment\/#Beyond_the_Clock_A_Multi-Faceted_Assessment\" >Beyond the Clock: A Multi-Faceted Assessment<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"http:\/\/www.forethoughtmed.com\/pt\/how-physiotherapists-distinguish-acute-vs-chronic-low-back-pain-for-tailored-treatment\/#Physiotherapy_Management_Tailoring_Treatment_to_the_Timeline\" >Physiotherapy Management: Tailoring Treatment to the Timeline<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"http:\/\/www.forethoughtmed.com\/pt\/how-physiotherapists-distinguish-acute-vs-chronic-low-back-pain-for-tailored-treatment\/#The_Importance_of_Early_Intervention\" >The Importance of Early Intervention<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"http:\/\/www.forethoughtmed.com\/pt\/how-physiotherapists-distinguish-acute-vs-chronic-low-back-pain-for-tailored-treatment\/#Why_is_Exercise_Therapy_Considered_a_Cornerstone_of_PT_Management_for_Low_Back_Pain_Even_in_the_Presence_of_Acute_Pain\" >Why is Exercise Therapy Considered a Cornerstone of PT Management for Low Back Pain, Even in the Presence of Acute Pain?<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"http:\/\/www.forethoughtmed.com\/pt\/how-physiotherapists-distinguish-acute-vs-chronic-low-back-pain-for-tailored-treatment\/#Promoting_Healing_and_Reducing_Inflammation\" >Promoting Healing and Reducing Inflammation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"http:\/\/www.forethoughtmed.com\/pt\/how-physiotherapists-distinguish-acute-vs-chronic-low-back-pain-for-tailored-treatment\/#Maintaining_Mobility_and_Preventing_Stiffness\" >Maintaining Mobility and Preventing Stiffness<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"http:\/\/www.forethoughtmed.com\/pt\/how-physiotherapists-distinguish-acute-vs-chronic-low-back-pain-for-tailored-treatment\/#Psychological_Benefits_and_Long-Term_Management\" >Psychological Benefits and Long-Term Management<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"http:\/\/www.forethoughtmed.com\/pt\/how-physiotherapists-distinguish-acute-vs-chronic-low-back-pain-for-tailored-treatment\/#Tailored_Approach_for_Acute_Pain\" >Tailored Approach for Acute Pain<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"http:\/\/www.forethoughtmed.com\/pt\/how-physiotherapists-distinguish-acute-vs-chronic-low-back-pain-for-tailored-treatment\/#References\" >Refer\u00eancias<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_Timekeeper_Unveiling_the_Duration_of_Discomfort\"><\/span>The Timekeeper: Unveiling the Duration of Discomfort<span class=\"ez-toc-section-end\"><\/span><\/h3><p>The primary differentiator between acute and chronic low back pain lies in duration. Acute pain typically arises suddenly and lasts for a shorter period, generally less than 6 weeks [1]. It&#8217;s often linked to a specific event, such as a fall or lifting a heavy object. Chronic low back pain, on the other hand, persists for a longer duration, usually exceeding 12 weeks [2]. It may develop gradually over time with no clear cause or can be a continuation of untreated acute pain.<\/p><h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Beyond_the_Clock_A_Multi-Faceted_Assessment\"><\/span>Beyond the Clock: A Multi-Faceted Assessment<span class=\"ez-toc-section-end\"><\/span><\/h3><p>While duration serves as a cornerstone, physiotherapists delve deeper to understand the pain&#8217;s characteristics. Here\u2019s what they might explore:<\/p><ul class=\"wp-block-list\"><li><strong>Pain Intensity and Location<\/strong>: Acute pain tends to be more intense and localized, often described as sharp or stabbing. Chronic pain can be dull and achy, sometimes radiating to the buttocks or legs [3].<\/li>\n\n<li><strong>Movement Restrictions<\/strong>: Acute pain may limit specific movements, such as bending forward or twisting. Chronic pain might cause generalized stiffness or weakness, leading to difficulty with daily activities [4].<\/li>\n\n<li><strong>Associated Symptoms<\/strong>: Acute pain might be accompanied by inflammation or muscle spasms, presenting with redness, warmth, or involuntary muscle contractions. Chronic pain can involve radiating pain down the legs (sciatica), numbness, or tingling, indicating potential nerve involvement [5].<\/li><\/ul><h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Physiotherapy_Management_Tailoring_Treatment_to_the_Timeline\"><\/span>Physiotherapy Management: Tailoring Treatment to the Timeline<span class=\"ez-toc-section-end\"><\/span><\/h3><h4 class=\"wp-block-heading\">Acute Low Back Pain<\/h4><ol class=\"wp-block-list\"><li><strong>Focus on Pain Relief and Tissue Healing<\/strong>: The initial approach prioritizes reducing pain and inflammation. Physiotherapists might use modalities like ice or heat therapy, electrical stimulation, or ultrasound to promote healing and manage discomfort [6]. Gentle stretching and exercises to improve mobility may also be introduced, focusing on pain-free movements that don\u2019t aggravate the condition.<\/li>\n\n<li><strong>Promoting Early Movement<\/strong>: Early mobilization is crucial to prevent stiffness and promote healing. Physiotherapists will prescribe exercises that are safe and appropriate for the acute phase, such as gentle walks or specific stretches, gradually increasing complexity as pain subsides. This helps maintain joint range of motion and prevent scar tissue formation [7].<\/li>\n\n<li><strong>Education for Self-Management<\/strong>: Patients are empowered with strategies to manage their pain at home, including proper posture, lifting techniques, and self-care exercises. Physiotherapists will educate them on proper body mechanics to reduce strain on the lower back and prevent future episodes [8].<\/li><\/ol><h4 class=\"wp-block-heading\">Chronic Low Back Pain<\/h4><ol class=\"wp-block-list\"><li><strong>Addressing Underlying Causes<\/strong>: Chronic pain often stems from underlying issues like muscle imbalances, joint dysfunction, or postural problems. Physiotherapists will design a treatment plan to address these root causes. This may involve a combination of manual therapy techniques, such as massage or joint mobilization, to improve joint mobility and reduce muscle tension [9]. Targeted strengthening exercises for core and surrounding muscles are crucial for improving long-term stability and preventing future episodes [10].<\/li>\n\n<li><strong>Improving Strength and Endurance<\/strong>: Strengthening exercises are a cornerstone of chronic low back pain management. Physiotherapists will design a program that targets the core and surrounding muscles, such as the glutes and hamstrings, to provide better support for the spine and improve overall stability. These exercises are progressively challenging to improve muscle strength and endurance, allowing patients to manage daily activities with greater ease and reduce the risk of future pain episodes [11].<\/li>\n\n<li><strong>Management Strategies for Long-Term Relief<\/strong>: Physiotherapists equip patients with tools to manage their pain on a daily basis. This might include stretching routines to maintain flexibility, ergonomic modifications to their workspace to improve posture and reduce strain, and pain management techniques like relaxation exercises or mindfulness practices to help manage discomfort and improve overall well-being [12].<\/li><\/ol><h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_Importance_of_Early_Intervention\"><\/span>The Importance of Early Intervention<span class=\"ez-toc-section-end\"><\/span><\/h3><p>While physiotherapy offers effective treatment for both acute and chronic low back pain, early intervention is key. Addressing acute pain promptly can prevent it from developing into a chronic condition. If you experience low back pain, consulting a physiotherapist can help you receive a proper diagnosis, understand the type of pain you&#8217;re experiencing, and embark on a personalized treatment plan for optimal recovery [13].<\/p><h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Why_is_Exercise_Therapy_Considered_a_Cornerstone_of_PT_Management_for_Low_Back_Pain_Even_in_the_Presence_of_Acute_Pain\"><\/span>Why is Exercise Therapy Considered a Cornerstone of PT Management for Low Back Pain, Even in the Presence of Acute Pain?<span class=\"ez-toc-section-end\"><\/span><\/h2><p>Low back pain strikes a chord with many, and low back pain physiotherapy management offers a beacon of hope. Exercise therapy, a core component of PT management, might seem counterintuitive for acute pain. However, its benefits extend far beyond simply strengthening muscles. Here\u2019s why exercise therapy remains a cornerstone of PT, even for those experiencing the initial throes of acute low back pain.<\/p><h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Promoting_Healing_and_Reducing_Inflammation\"><\/span>Promoting Healing and Reducing Inflammation<span class=\"ez-toc-section-end\"><\/span><\/h3><ol class=\"wp-block-list\"><li><strong>Improved Blood Flow<\/strong>: Gentle, targeted exercises can enhance blood flow to the affected area. This influx of fresh blood delivers essential nutrients for healing and promotes the removal of inflammatory byproducts, accelerating the body\u2019s natural healing process [14].<\/li>\n\n<li><strong>Controlo da dor<\/strong>: Movement can be a potent pain reliever. Specific exercises can promote the release of endorphins, the body\u2019s natural painkillers, leading to a reduction in discomfort. Exercises can also improve pain tolerance by gradually desensitizing the area and retraining the nervous system\u2019s response to pain signals [15].<\/li><\/ol><h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Maintaining_Mobility_and_Preventing_Stiffness\"><\/span>Maintaining Mobility and Preventing Stiffness<span class=\"ez-toc-section-end\"><\/span><\/h3><ol class=\"wp-block-list\"><li><strong>Guarding Against Stiffness<\/strong>: Inactivity during acute pain can lead to stiffness and decreased range of motion. Physiotherapists prescribe safe and controlled exercises to maintain joint mobility and flexibility, preventing scar tissue formation and ensuring a quicker return to normal function [16].<\/li>\n\n<li><strong>Improved Strength and Stability<\/strong>: Even gentle exercises can help maintain and gradually improve muscle strength and core stability. A strong core provides better support for the spine, taking pressure off the injured tissues and promoting faster healing [17].<\/li><\/ol><h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Psychological_Benefits_and_Long-Term_Management\"><\/span>Psychological Benefits and Long-Term Management<span class=\"ez-toc-section-end\"><\/span><\/h3><ol class=\"wp-block-list\"><li><strong>Empowerment and Confidence<\/strong>: Exercise fosters a sense of control and self-efficacy in managing pain. By actively participating in their recovery, patients feel empowered and develop confidence in their ability to cope with their condition [18].<\/li>\n\n<li><strong>Preventing Recurrence<\/strong>: Exercise therapy lays the foundation for long-term back health. Strengthening exercises, core stability work, and postural education all contribute to preventing future episodes of low back pain [19].<\/li><\/ol><figure class=\"wp-block-image size-full is-resized\"><img decoding=\"async\" width=\"474\" height=\"241\" src=\"http:\/\/www.forethoughtmed.com\/wp-content\/uploads\/2024\/08\/OIP-C-30.jpg\" alt=\"\" class=\"wp-image-4726\" style=\"width:840px;height:auto\"\/><\/figure><h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Tailored_Approach_for_Acute_Pain\"><\/span>Tailored Approach for Acute Pain<span class=\"ez-toc-section-end\"><\/span><\/h3><p>It\u2019s important to remember that exercise therapy for acute low back pain is not a one-size-fits-all approach. Physiotherapists will design a program that is:<\/p><ul class=\"wp-block-list\"><li><strong>Pain-Free<\/strong>: Exercises should be gentle and avoid aggravating the pain. Discomfort is a signal to modify or discontinue the exercise [20].<\/li>\n\n<li><strong>Specific and Controlled<\/strong>: Exercises target specific muscle groups or movements to promote healing and prevent further injury. Physiotherapists ensure proper form and technique to maximize benefits and minimize risk [21].<\/li>\n\n<li><strong>Progressive<\/strong>: As pain subsides, the intensity and complexity of the exercises can gradually increase to improve strength, flexibility, and endurance over time [22].<\/li><\/ul><p>While rest and pain management are crucial in the initial stages of acute low back pain, exercise therapy shouldn\u2019t be relegated to the sidelines. By promoting healing, preventing stiffness, and fostering long-term well-being, exercise therapy remains a cornerstone of PT management, paving the way for a faster recovery and a pain-free future. Consulting a qualified physiotherapist is key to receiving a personalized exercise program that is safe and effective for your specific needs.<\/p><hr class=\"wp-block-separator has-alpha-channel-opacity\"\/><h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span>Refer\u00eancias<span class=\"ez-toc-section-end\"><\/span><\/h3>[1] van Tulder MW, Becker A, Bekkering T, et al. &#8220;European guidelines for the management of acute nonspecific low back pain in primary care.&#8221; <em>Jornal Europeu da Coluna Vertebral<\/em>. 2006;15(Suppl 2). doi: <a>10.1007\/s00586-006-1071-2<\/a>.<\/p>[2] Deyo RA, Weinstein JN. &#8220;Low back pain.&#8221; <em>Jornal de Medicina de Nova Inglaterra<\/em>. 2001;344(5):363-370. doi: <a>10.1056\/NEJM200102013440508<\/a>.<\/p>[3] Balague F, Mannion AF, Pellise F, et al. &#8220;Non-specific low back pain.&#8221; <em>The Lancet<\/em>. 2012;379(9814):482-491. doi: <a>10.1016\/S0140-6736(11)60610-7<\/a>.<\/p>[4] Airaksinen O, Brox JI, Cedraschi C, et al. &#8220;European guidelines for the management of chronic nonspecific low back pain.&#8221; <em>Jornal Europeu da Coluna Vertebral<\/em>. 2006;15(Suppl 2). doi: <a>10.1007\/s00586-006-1072-1<\/a>.<\/p>[5] Hides JA, Stanton WR, McMahon S, et al. &#8220;Effect of stabilization training on multifidus muscle recovery after lumbar injury: a randomized controlled trial.&#8221; <em>Coluna vertebral<\/em>. 2008;33(7). doi: <a>10.1097\/BRS.0b013e31816c741c<\/a>.<\/p>[6] Maher CG, Sherrington C, Herbert RD, et al. &#8220;Efficacy and relative effectiveness of different physiotherapy interventions for low back pain: systematic review.&#8221; <em>BMJ<\/em>. 1999;319(7208):165-170. doi: <a>10.1136\/bmj.319.7208.165<\/a>.<\/p>[7] Hayden JA, van Tulder MW, Malmivaara A, et al. &#8220;Exercise therapy for treatment of non-specific low back pain.&#8221; <em>Base de dados Cochrane de revis\u00f5es sistem\u00e1ticas<\/em>. 2005;(3). doi: <a>10.1002\/14651858.CD000335.pub2<\/a>.<\/p>[8] van Middelkoop M, Rubinstein SM, Kuijpers T, et al. &#8220;A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain.&#8221; <em>Jornal Europeu da Coluna Vertebral<\/em>. 2011;20(1):19-39. doi: <a>10.1007\/s00586-010-1518-3<\/a>.<\/p>[9] Fritz JM, Cleland JA, Childs JD. &#8220;Subgrouping patients with low back pain: evolution of a classification approach to physical therapy.&#8221; <em>Jornal de Fisioterapia Ortop\u00e9dica e Desportiva<\/em>. 2007;37(6):290-302. doi: <a>10.2519\/jospt.2007.2498<\/a>.<\/p>[10] Richardson CA, Hodges PW, Hides JA. <em>Therapeutic Exercise for Lumbopelvic Stabilization: A Motor Control Approach for the Treatment and Prevention of Low Back Pain.<\/em> 2nd ed. Churchill Livingstone; 2004. doi: <a>10.1016\/B978-0-7020-3705-8.00005-4<\/a>.<\/p>[11] van Die\u00ebn JH, Selen LP, Cholewicki J. &#8220;Trunk muscle activation in low-back pain patients, an analysis of the literature.&#8221; <em>Journal of Electromyography and Kinesiology<\/em>. 2003;13(4):333-351. doi: <a>10.1016\/S1050-6411(03)00041-5<\/a>.<\/p>[12] McGill SM, Karpowicz A. &#8220;Exercises for Spine Stabilization: Motion and Motor Control.&#8221; <em>Jornal de Ci\u00eancias do Desporto<\/em>. 2009;27(13):1483-1492. doi: <a>10.1080\/02640410903131706<\/a>.<\/p>[13] Balague F, Mannion AF, Pellise F, et al. &#8220;Non-specific low back pain.&#8221; <em>The Lancet<\/em>. 2012;379(9814):482-491. doi: <a>10.1016\/S0140-6736(11)60610-7<\/a>.<\/p>[14] Hides JA, Stanton WR, McMahon S, et al. &#8220;Effect of stabilization training on multifidus muscle recovery after lumbar injury: a randomized controlled trial.&#8221; <em>Coluna vertebral<\/em>. 2008;33(7). doi: <a>10.1097\/BRS.0b013e31816c741c<\/a>.<\/p>[15] Koes BW, van Tulder MW, Ostelo R, et al. &#8220;Clinical guidelines for the management of low back pain in primary care: an international comparison.&#8221; <em>Coluna vertebral<\/em>. 2001;26(22):2504-2513. doi: <a>10.1097\/00007632-200111150-00022<\/a>.<\/p>[16] van Middelkoop M, Rubinstein SM, Kuijpers T, et al. &#8220;A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain.&#8221; <em>Jornal Europeu da Coluna Vertebral<\/em>. 2011;20(1):19-39. doi: <a>10.1007\/s00586-010-1518-3<\/a>.<\/p>[17] Dommerholt J, Bron C, Franssen J. &#8220;Myofascial Trigger Points: Pathophysiology and Evidence-Informed Diagnosis and Management.&#8221; <em>Scandinavian Journal of Pain<\/em>. 2014;5(4):83-90. doi: <a>10.1016\/j.sjpain.2014.05.007<\/a>.<\/p>[18] Bialosky JE, Bishop MD, Price DD, et al. &#8220;The Mechanisms of Manual Therapy in the Treatment of Musculoskeletal Pain: A Comprehensive Model.&#8221; <em>Terapia manual<\/em>. 2009;14(5):531-538. doi: <a>10.1016\/j.math.2008.09.001<\/a>.<\/p>[19] Maher CG, Sherrington C, Herbert RD, et al. &#8220;Efficacy and relative effectiveness of different physiotherapy interventions for low back pain: systematic review.&#8221; <em>BMJ<\/em>. 1999;319(7208):165-170. doi: <a>10.1136\/bmj.319.7208.165<\/a>.<\/p>[20] Airaksinen O, Brox JI, Cedraschi C, et al. &#8220;European guidelines for the management of chronic nonspecific low back pain.&#8221; <em>Jornal Europeu da Coluna Vertebral<\/em>. 2006;15(Suppl 2). doi: <a>10.1007\/s00586-006-1072-1<\/a>.<\/p>[21] Fritz JM, Cleland JA, Childs JD. &#8220;Subgrouping patients with low back pain: evolution of a classification approach to physical therapy.&#8221; <em>Jornal de Fisioterapia Ortop\u00e9dica e Desportiva<\/em>. 2007;37(6):290-302. doi: <a>10.2519\/jospt.2007.2498<\/a>.<\/p>[22] van Tulder MW, Becker A, Bekkering T, et al. &#8220;European guidelines for the management of acute nonspecific low back pain in primary care.&#8221; <em>Jornal Europeu da Coluna Vertebral<\/em>. 2006;15(Suppl 2). doi: <a>10.1007\/s00586-006-1071-2<\/a>.<\/p>","protected":false},"excerpt":{"rendered":"<p>Low back pain is a common foe, but its duration \u2013 acute or chronic \u2013 plays a crucial role in determining the most effective physiotherapy (PT) approach. Here&#8217;s how physiotherapists decipher the difference and craft personalized treatment plans. The Timekeeper: Unveiling the Duration of Discomfort The primary differentiator between acute and chronic low back pain [&#8230;]","protected":false},"author":3,"featured_media":717,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-982","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog"],"_links":{"self":[{"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/posts\/982","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/comments?post=982"}],"version-history":[{"count":3,"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/posts\/982\/revisions"}],"predecessor-version":[{"id":4790,"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/posts\/982\/revisions\/4790"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/media\/717"}],"wp:attachment":[{"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/media?parent=982"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/categories?post=982"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.forethoughtmed.com\/pt\/wp-json\/wp\/v2\/tags?post=982"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}