Medicine and Health Sciences


Non-specific Low Back Pain (LBP) is a major problem that carries a large cost, both economically and socially, as more than 80% of health care costs are a result of these types of conditions.3 Approximately 10-20% of people with low back pain develop Chronic Low Back Pain (CLBP), which is pain and disability persisting for more than three months.3 Back pain is one of the most common reasons a patient is referred to physical therapy. One of the largest issues CLBP patients experience is pain. It is often referred to as the chronic pain cycle, which can start anywhere, but follows through the steps of muscle tension, reduced circulation, muscle inflammation and reduced movement, circling back to pain. One way to give these patients relief is by putting them in water. Depending on the water level, the body weight supported by the patient is reduced. (See Appendix A).

Back pain needs to be approached in a multifaceted manner because there is no single cause to account for all incidences. There are multiple treatment/management interventions to approach the problem of low back pain including: manual therapy, trunk coordination/strengthening/endurance, centralization procedures following the McKenzie approach, flexion exercises, traction, education and counseling, and progressive endurance/fitness activities. These have been studied more thoroughly than using hydrotherapy, by itself or in combination with other therapies. There is no universal recommendation on how to approach back pain in the water and this guideline seeks to review a few different articles to see what other researchers did and what outcome these patients experienced. It will also look into recommendations from an aquatic therapist, limitations in the research, and how to overcome these in future studies.