Physical therapy: a critique.

Some forms of physical therapy are used relatively frequently in the treatment of chronic musculoskeletal pain conditions, including the temporomandibular disorders. We found evidence that cold seems to be a useful treatment for postsurgical pain and swelling and that most patients being treated for most chronic musculoskeletal pain seem to do better with most forms of therapy. However, we agree with the authors of previous reviews that there is little evidence that these methods of management cause long-lasting reductions in signs and symptoms. Findings of recent clinical trials tend to support this conclusion, although evidence is beginning to accumulate that exercise programs designed to improve physical fitness have beneficial effects on chronic pain and disability of the musculoskeletal system.