The expression by the APA seems to recognise that LBP has a mechanical origin and ignores the psycho-social effects of pain. I both agree and disagree with their statement. The 'cure' is basically physical but the client has to be able to participate in the process. If they view their pain as precluding participation in therapy then they will need a modality to reduce pain to the point they can participate. This could vary from encouragement to opiates and includes EPA's, Many patients react positively to EPA's e.g. IFT and need this input to gain the confidence to participate. After thirty odd years of practising I am of the opinion getting people better is about getting them to participate and if the machine that goes BING is needed, use it. Theory is fine but putting your patient into the equation is essential as a therapist you must treat both the physical problem and the patients outlook. Ignoring the client's personality and reaction to pain is at your's and their peril. They need to be able to relax and listen to your explanation and therapeutic reasoning because if they don't hear it and appreciate it they react on a primal basis guarding and protecting. They will trust you more if they experience pain relief however this is generated; IFT will relieve pain and, perhaps decrease spasm, as much as gentle manual therapy, its the outcome not the means that matters.