Q: I'm seeing a physiotherapist for low back pain that just won't go away. Every session is like attending a motivational conference. Is all the counseling, information, and rah-rah really necessary?

A: You may be a unique individual who can grasp the concepts and move ahead without much supervision. Most people seem to need additional support and encouragement to stay the course.

In fact several studies have been done to show that most adults don't stick with an exercise program for their back pain. This is true even when exercise has been shown over and over to reduce back pain.

At the University of Vienna in Austria, researchers recently reported on a long-term study with chronic back pain patients. Two groups were included: exercise only (control group) and a group that did exercise and received motivational counseling.

The motivational group had twice the results of the exercise-only group. Five years later they still had better function, less pain, and better work ability. Evidently there's something about the rah-rah that works!

Martin Friedrich, MD, et al. Long-Term Effect of a Combined Exercise and Motivational Program on the Level of Disability of Patients with Chronic Low Back Pain. In Spine. May 1, 2005. Vol. 30. No. 9. Pp. 995-1000.