Back pain and the therapeutic alliance.

Many therapists have noticed that those back pain patients they can build a good relationship with as quickly as possible, often do better, quicker.

Now recent research has examined the effect of this therapeutic alliance in chronic low back pain patients. Patients with long term back pain were randomly assigned to one of four groups. Two groups had sham interferential current therapy and two had real interferential current therapy ( what one of my patients described as “the tingly thing”). These groups were then divided again into those who had limited therapeutic alliance and those who had enhanced therapeutic alliance.

Perhaps unsurprisingly to everyone, the group who received real interferential with enhanced therapeutic alliance had clinically meaningful results.

This study showed what others have shown using different therapies, that no matter what the treatment, the context the physical therapy is delivered in has the potential to dramatically enhance the therapy.

I guess the good news for you guys is that my team being nice to you whilst offering high quality physiotherapy interventions will do you even more good!

Will this signify the end for the term ” physio terrorist “.


if you or anyone you know would like to see one of our physiotherapists for a physiotherapy assessment or treatment, please contact us.

Fuentes J et al. Enhanced therapeutic alliance modulates pain intensity and muscle pain sensitivity in patients with chronic low back pain: An experimental controlled study. Physical therapy 2014;