Stay active if you're struggling with back pain, and you may do just as well as those who go to physical therapy sessions. That's the conclusion of a new study in the Sept. 25 issue of the British Medical Journal. Researchers from the University of Warwick divided patients who had experienced low back pain for at least six weeks into two groups. One hundred forty-two people were assigned to an "advice" group, and 144 were assigned to a therapy group from late 1997 through January 2001. The advice group received one session with a physiotherapist (also called a physical therapist), who conducted a physical exam and gave general advice on how to remain active. The session lasted for up to one hour. Those in the therapy group also got a physical exam by a physiotherapist that lasted up to an hour. The therapist then treated each patient during additional sessions -- usually six or fewer -- of about a half hour each. Patients in the therapy group were more likely to report benefits from therapy at two and six months. But at the 12-month follow-up, 70 percent of all the patients provided feedback, and only minor differences existed between the two groups. No differences in scores on a commonly used disability index were found between the groups. "As far as we know there have been no other trials like this," said study co-author Sarah Stewart-Brown, a professor of public health at the University of Warwick. International guidelines for treating low back pain vary, according to the authors, although all experts agree that patients should be told to stay physically active. Most advise exercise therapy for those with chronic low back pain. "Back pain tends to get better on its own," Stewart-Brown said. "But some patients in both groups followed the advice they were offered and changed their lifestyles in ways which would improve their backs." So if a health insurance plan offers you extensive physical therapy, are you wise to use it? "On the basis of these results, I would turn down the sort of physiotherapy which is currently offered in the U.K. National Health Service," Stewart-Brown said. In an accompanying editorial, Dr. Domhnall MacAuley, a general practitioner at a family practice office in Belfast, Northern Ireland, said, "The best option is to follow an advice sheet and remain active." He questioned whether patients should be referred to physical therapists in the wake of the study findings showing no apparent long-term benefit. The best thing to do, MacAuley added, is to "remain active, take simple analgesia, and seek help on appropriate exercises. There is also some evidence that chiropractic can help."