Wright A, Sluka K A
School of Medical Rehabilitation, University of Manitoba, Winnipeg.
Clin J Pain. 2001 Mar;17(1):33-46. doi: 10.1097/00002508-200103000-00006.
Several types of physical therapy are used in the management of painful musculoskeletal disorders. These treatment modalities can be broadly categorized as electrotherapy modalities (e.g., transcutaneous electrical nerve stimulation), acupuncture, thermal modalities (e.g., moist heat, ultrasound), manual therapies (e.g., manipulation or massage), or exercise. Within each of these broad categories significant variations in treatment parameters are possible.
To consider the evidence base for each of these main categories of physical therapy in the management of musculoskeletal pain.
To consider the available evidence related to clinical effectiveness and then to review evidence from basic science studies evaluating potentially therapeutic effects of the various therapies.
There seems to be evidence from basic science research to suggest that many of the therapies could have potentially therapeutic effects. However, there appears to be limited high-quality evidence from randomized clinical trials to support the therapeutic effectiveness of several of the therapies.
There is some preliminary evidence to support the use of manual therapies, exercise, and acupuncture in the management of some categories of musculoskeletal pain. Limitations of the existing research base are discussed and recommendations for areas of future research are provided.
几种物理治疗方法用于疼痛性肌肉骨骼疾病的管理。这些治疗方式可大致分为电疗法（如经皮电刺激神经疗法）、针灸、热疗法（如湿热敷、超声波）、手法治疗（如整复或按摩）或运动疗法。在这些大类中的每一类中，治疗参数都可能存在显著差异。
探讨这些主要物理治疗类别在肌肉骨骼疼痛管理中的证据基础。
考虑与临床疗效相关的现有证据，然后回顾基础科学研究中评估各种疗法潜在治疗效果的证据。
基础科学研究似乎有证据表明，许多疗法可能具有潜在治疗效果。然而，随机临床试验中高质量证据似乎有限，无法支持其中几种疗法的治疗效果。
有一些初步证据支持手法治疗、运动疗法和针灸用于某些类别的肌肉骨骼疼痛管理。讨论了现有研究基础的局限性，并提供了未来研究领域的建议。
