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Low Back Pain Nonmedical Monotherapies
From WikiMSK
Traction
Moderate-quality evidence of little or no impact on pain intensity compared with sham treatment [1][2]
Manual Therapy
- Not superior to other interventions for improving pain and function
- High-quality statistically significant evidence for small improvements in pain at 1 month and 6 months and function at 1 month compared with other active interventions. No long-term effect on function. Effects not clinically relevant.
- Very-low-quality evidence that not more effective than other inert/sham interventions
Acupuncture
- Low-quality evidence of better immediate (0-7 days) and short-term (1wk - 3mths) pain relief and functional improvement than sham or no treatment, or oral analgesics: 7- to 24-point immediate improvement in pain on 0- to 100-point scale
- Moderate-quality evidence of no long-term benefit
- May be a useful adjunct to other therapies
Massage
- Very-low- to low-quality evidence of benefit: -0.6 to -0.94 reduction in 0 to10 point pain scale
- Slightly better short-term pain relief and function than sham therapy, waiting list or no treatment
- Slightly better short-term pain relief than manipulation, mobilisation, acupuncture, traction, relaxation, physiotherapy, exercises, TENS or self-care education
- AE: Increased pain intensity in 1.5-25%
Behavioural Therapy
- Moderate-quality evidence that more effective than usual care for short-term pain relief
- Moderate-quality evidence that no intermediate- or long-term effect on pain or function[11][12]
Back School
- Education and exercise, therapeutic programme, often for groups. Started in 1969 with the Swedish Back School
- Only very-low quality evidence available. Uncertain if effective: no difference or trivial effect in favour of Back School[13]
Exercises
- Mixed statements: low- to high-quality evidence: slightly effective at improving short-, intermediate- and long-term pain and function
- Individually designed strengthening or stabilising programs appear to be effective in healthcare settings
Physical Activity
- Low-quality evidence that may improve pain severity and physical function, and quality of life in short-, medium- and long-term
- Walking as good as other forms of physical activity
- Low-quality evidence that exercise is better than hands-on therapy for reducing pain and improving function
Yoga
Low- to moderate-quality evidence: may provide small to moderate improvements in function at 3 and 6 months compared to non-exercise controls, and may also be slightly more effective for pain at 3 and 6 months [20]
Pilates
Low- to moderate-quality evidence: more effective than minimal intervention for pain and disability short- and intermediate-term; possibly slightly superior to other exercises at improving pain and disability at intermediate-term follow-up (3-12 months)[21][17]
Cognitive Functional Therapy
Mindfulness
- Possibly better improvements in short-term pain and function compared with usual care or education
- No differences between outcomes for mindfulness versus CBT
See Also
References
This article is still missing information.
- โ James McKivigan, Brittany Krisak, Brittni Vogel, Ashley Harrington, Van Nguyen. Evaluating the Efficacy of Vertebral Axial Decompression Therapy in Treatment of Patients with Chronic Lower Back Pain: A Systematic Review. Rehabilitation Science. Vol. 4, No. 2, 2019, pp. 25-34. doi: 10.11648/j.rs.20190402.12
- โ Cochrane: WegnerI, WidyaheningIS, van TulderMW, BlombergSEI, de VetHCW, BrรธnfortG, BouterLM, van der HeijdenGJ.Traction for low-back pain with or without sciatica. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD003010. DOI: 10.1002/14651858.CD003010.pub5.
- โ Zoete A de et al, (2018) Effectiveness of spinal manipulative therapy for chronic low back pain: results from an individual participant data-meta-analysis, Orthopaedic Proceedings Vol 101-B(supp 9). The Society for Back Pain Research (SBPR) 2018 Meeting, Groningen, The Netherlands, 15โ16 November 2018.
- โ Chou et al (2017) Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017;166:xxx-xxx. doi:10.7326/M16-2459
- โ RubinsteinSM, van MiddelkoopM, AssendelWJJ, de BoerMR, van TulderMW. Spinal manipulative therapy for chronic low-back pain. Cochrane Database of Systematic Reviews 2011, Issue 2. Art. No.: CD008112. DOI: 10.1002/14651858.CD008112.pub2.
- โ FurlanAD, van TulderMW, CherkinD, TsukayamaH, LaoL, KoesBW, BermanBM. Acupuncture and dry-needling for low back pain. Cochrane Database of Systematic Reviews 2005, Issue 1. Art. No.: CD001351. DOI: 10.1002/14651858.CD001351.pub2.
- โ Xiang Y, He JY, Tian HH, Cao BY, Li R. Evidence of efficacy of acupuncture in the management of low back pain: a systematic review and meta-analysis of randomised placebo- or sham-controlled trials. Acupunct Med. 2020;38(1):15-24. doi:10.1136/acupmed-2017-011445
- โ Chou et al (2017) Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017;166:xxx-xxx. doi:10.7326/M16-2459
- โ Chou et al (2017) Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017;166:xxx-xxx. doi:10.7326/M16-2459
- โ FurlanAD, GiraldoM, BaskwillA, IrvinE, ImamuraM. Massage for low-back pain. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No.: CD001929. DOI: 10.1002/14651858.CD001929.pub3.
- โ HenschkeN, OsteloRWJG, van TulderMW, VlaeyenJWS, MorleyS, Assendel&WJJ, MainCJ. Behavioural treatment for chronic low-back pain. Cochrane Database of Systematic Reviews 2010, Issue 7. Art. No.: CD002014. DOI: 10.1002/14651858.CD002014.pub3.
- โ Chou et al (2017) Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017;166:xxx-xxx. doi:10.7326/M16-2459
- โ ParreiraP, HeymansMW, van TulderMW, EsmailR, KoesBW, PoquetN, LinCWC, MaherCG. Back Schools for chronic non-specific low back pain. Cochrane Database of Systematic Reviews 2017, Issue 8. Art. No.: CD011674. DOI: 10.1002/14651858.CD011674.pub2.
- โ Owen PJ, Miller CT, Mundell NL, et al. Br J Sports Med Epub ahead of print doi:10.1136/ bjsports-2019-100886
- โ HaydenJ, van TulderMW, MalmivaaraA, KoesBW. Exercise therapy for treatment of non-specific low back pain. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No.: CD000335. DOI: 10.1002/14651858.CD000335.pub2.
- โ Chou et al (2017) Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017;166:xxx-xxx. doi:10.7326/M16-2459
- โ 17.0 17.1 Owen PJ, Miller CT, Mundell NL, et al. Br J Sports Med Epub ahead of print doi:10.1136/ bjsports-2019-100886
- โ Walking vs. Other Exercise for Chronic Low Back Pain โ Systematic Review & Meta-Analysis Disability and Rehabilitation 2017; 5: 1-11. DOI: 10.1080/09638288.2017.1410730
- โ GeneenLJ, MooreRA, ClarkeC, MartinD, ColvinLA, SmithBH. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database of Systematic Reviews 2017, Issue 4. Art. No.: CD011279. DOI: 10.1002/14651858.CD011279.pub3.
- โ WielandLS, SkoetzN, PilkingtonK, VempatiR, D'AdamoCR, BermanBM. Yoga treatment for chronic non-specific low back pain. Cochrane Database of Systematic Reviews 2017, Issue 1. Art. No.: CD010671. DOI: 10.1002/14651858.CD010671.pub2.
- โ YamatoTP, MaherCG, SaragiottoBT, HancockMJ, OsteloRWJG, CabralCMN, Menezes CostaLC, CostaLOP. Pilates for low back pain. Cochrane Database of Systematic Reviews 2015, Issue 7. Art. No.: CD010265. DOI: 10.1002/14651858.CD010265.pub2.
- โ Chou et al (2017) Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017;166:xxx-xxx. doi:10.7326/M16-2459