scholarly journals Effectiveness of ozone therapy compared to other therapies for low back pain: a systematic review with meta-analysis of randomized clinical trials

2019 ◽  
Vol 69 (5) ◽  
pp. 493-501 ◽  
Author(s):  
Raul Ribeiro de Andrade ◽  
Olavo Barbosa de Oliveira-Neto ◽  
Luciano Timbó Barbosa ◽  
Isabelle Oliveira Santos ◽  
Célio Fernando de Sousa-Rodrigues ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Low Back Pain ◽  
Back Pain ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Low Back ◽  
Ozone Therapy

scholarly journals EXTRACORPOREAL SHOCK WAVE THERAPY (ESWT) IN CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW OF RANDOMIZED CLINICAL TRIALS

2020 ◽  
Vol 13 (4) ◽  
pp. 1-16
Author(s):  
Karolina Walewicz
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Randomized Clinical Trials ◽  
Extracorporeal Shock Wave Therapy ◽  
Low Back ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave

Background: Extracorporeal Shock Wave Therapy (ESWT) has become a popular tool to treat musculoskeletal disorders and chronic low back pain. Aim of the study: To review the current scientific literature and assess the utility of ESWT in treating chronic low back pain. Methods: This systematic review was conducted from November 2019 to January 2020. Its purpose was to determine what the effectiveness is of the various forms of ESWT for the treatment of chronic low back pain. The critical review of the literature on the use of ESWT in chronic low back was made using the scientifically recognized medical databases PubMed, MEDLINE, Physiotherapy Evidence Database (PEDro) and Web of Science Core Collection. There was no restriction by date. Exclusion criteria were experimental, in vitro, animal, review, case reports, non-randomized clinical trials or studies with healthy participants. All articles written in languages other than English have also been excluded. Results: Six studies were included in the final analysis. According to the applied PEDro classification, the average scoring for the studies was 4.83, which indicates overall low quality of the presented reports. However, this result appeared closer to the moderate (acceptable) quality range (6-8 points) than to the unacceptable range (0-2 points). Conclusion: Based on the findings in the analyzed articles, ESWT promises to be an efficient and useful procedure in chronic low back pain treatment. Unfortunately, the level of evidence is relatively weak because there are a limited number of published studies related to ESWT and the final score in the PEDro classification was low. Together, these results indicate the need for further high quality randomized clinical trials.

scholarly journals Are Older Adults Missing From Low Back Pain Clinical Trials? A Systematic Review and Meta-Analysis

2014 ◽  
Vol 66 (8) ◽  
pp. 1220-1226 ◽  
Author(s):  
Tatjana Paeck ◽  
Manuela L. Ferreira ◽  
Clive Sun ◽  
Chung-Wei Christine Lin ◽  
Anne Tiedemann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Clinical Trials ◽  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Low Back

scholarly journals Randomized Clinical Trials on Acupuncture in Korean Literature: A Systematic Review

2009 ◽  
Vol 6 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Jae Cheol Kong ◽  
Myeong Soo Lee ◽  
Byung-Cheul Shin
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Premenstrual Syndrome ◽  
Methodological Quality ◽  
Randomized Clinical Trials ◽  
Low Back ◽  
Korean Literature

The aim of this systematic review was to summarize randomized clinical trials (RCTs) assessing the effectiveness of acupuncture as published in Korean literature. Systematic searches were conducted on eight Korean medical databases. Manual searches were also conducted through eight major Korean medical journals. The methodological quality was assessed using a Jadad score. Studies evaluating needle acupuncture or auricular acupuncture (AA) with or without electrical stimulation were considered if they were sham or placebo-controlled or controlled against a comparative intervention. We also excluded acupuncture as an adjuvant to other treatments and other forms of acupuncture were excluded. Seven hundred and nine possibly relevant studies were identified and 10 RCTs were included. The methodological quality of the trials was generally poor. Manual acupuncture was compared to placebo acupuncture in four studies of patients with chronic low back pain, shoulder pain, premenstrual syndrome and allergic rhinitis. Three studies tested AA (two trials) and electroacupuncture (one trial) against no treatment, while three trials compared acupuncture with other active therapeutic controls. The methodological limitations of the included trials make their contribution to the current clinical evidence of acupuncture somewhat limited. The trial for premenstrual syndrome, shoulder pain and chronic low back pain added a limited contribution among those included RCTs. However, well-designed RCTs of acupuncture with a rigorous methodology are in progress or have been completed in Korea and will contribute to establish or contribute to the current progress of research in this field.

scholarly journals Virtual Reality in the Treatment of Adults with Chronic Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

2021 ◽  
Vol 18 (22) ◽  
pp. 11806
Author(s):  
Beatriz Brea-Gómez ◽  
Irene Torres-Sánchez ◽  
Araceli Ortiz-Rubio ◽  
Andrés Calvache-Mateo ◽  
Irene Cabrera-Martos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Virtual Reality ◽  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Chronic Low Back Pain ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Low Back

Virtual reality (VR) can present advantages in the treatment of chronic low back pain. The objective of this systematic review and meta-analysis was to analyze the effectiveness of VR in chronic low back pain. This review was designed according to PRISMA and registered in PROSPERO (CRD42020222129). Four databases (PubMed, Cinahl, Scopus, Web of Science) were searched up to August 2021. Inclusion criteria were defined following PICOS recommendations. Methodological quality was assessed with the Downs and Black scale and the risk of bias with the Cochrane Risk of Bias Assessment Tool. Fourteen studies were included in the systematic review and eleven in the meta-analysis. Significant differences were found in favor of VR compared to no VR in pain intensity postintervention (11 trials; n = 569; SMD = −1.92; 95% CI = −2.73, −1.11; p < 0.00001) and followup (4 trials; n = 240; SDM = −6.34; 95% CI = −9.12, −3.56; p < 0.00001); and kinesiophobia postintervention (3 trials; n = 192; MD = −8.96; 95% CI = −17.52, −0.40; p = 0.04) and followup (2 trials; n = 149; MD = −12.04; 95% CI = −20.58, −3.49; p = 0.006). No significant differences were found in disability. In conclusion, VR can significantly reduce pain intensity and kinesiophobia in patients with chronic low back pain after the intervention and at followup. However, high heterogeneity exists and can influence the consistency of the results.

scholarly journals Effect of Combined Diclofenac and B Vitamins (Thiamine, Pyridoxine, and Cyanocobalamin) for Low Back Pain Management: Systematic Review and Meta-analysis

Pain Medicine ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 766-781 ◽  
Author(s):  
Carlos-Alberto Calderon-Ospina ◽  
Mauricio Orlando Nava-Mesa ◽  
Carlos Emilio Arbeláez Ariza
Keyword(s):  
Clinical Trials ◽  
Low Back Pain ◽  
Back Pain ◽  
Combination Therapy ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Selective Reporting ◽  
Low Back ◽  
High Quality

Abstract Background Cumulative evidence suggests an analgesic effect of thiamine, pyridoxine, and cyanocobalamin (TPC) in monotherapy, and also when combined with nonsteroidal anti-inflammatory drugs (NSAIDs), particularly diclofenac, in a synergistic manner. The aim of this review was to determine the effects of diclofenac combined with TPC compared with diclofenac monotherapy for low back pain (LBP) management. Methods We searched for randomized clinical trials on the MEDLINE, EMBASE, LILACS, and Cochrane databases of records of clinical trials, among other sources. We evaluated the risk of bias regarding randomization, allocation concealment, blinding, incomplete outcome data, selective reporting, and other biases. A random-effects meta-analysis to examine patients with acute LBP (N = 1,108 adults) was performed, along with a subsequent sensitivity analysis. Results Five studies in patients with LBP were included in the qualitative synthesis. Four of these studies in acute LBP were included in the first meta-analysis. A sensitivity test based on risk of bias (three moderate- to high-quality studies) found that the combination therapy of diclofenac plus TPC was associated with a significant reduction in the duration of treatment (around 50%) compared with diclofenac monotherapy (odds ratio = 2.23, 95% confidence interval = 1.59 to 3.13, P &lt; 0.00001). We found no differences in the safety profile and patient satisfaction. Conclusions This meta-analysis demonstrated that combination therapy of diclofenac with TPC might have an analgesic superiority compared with diclofenac monotherapy in acute LBP. However, there is not enough evidence to recommend this therapy in other types of pain due to the scarcity of high-quality studies.

scholarly journals Drug Therapy for the Treatment of Chronic Nonspecific Low Back Pain: Systematic Review and Meta-analysis

2013 ◽  
Vol 6;16 (6;11) ◽  
pp. E685-E704 ◽  
Author(s):  
Joanne WY Chung
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Drug Therapy ◽  
Pain Relief ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Low Back ◽  
Cox 2 ◽  
The Impact

Background: Low back pain (LBP) is one of the most common health problems in adults. The impact of LBP on the individual can cause loss of health status in the form of symptoms and loss of function related to pain in the back; limitation of daily, leisure, and/or strenuous activities, and disability. LBP also poses an economic burden to society, mainly in terms of one of the most common reasons for seeking medical care (direct treatment costs), and accounts for the large number of work days lost (indirect costs). To reduce the impact of LBP on adults, drug therapy is the most frequently recommended intervention. Over the last decade, a substantial number of randomized clinical trials of drug therapy for LBP have been published. Objective: To determine the effectiveness of drug therapy for the treatment of chronic nonspecific low back pain (CNLBP). Study Design: Systematic review and meta-analysis Methods: A systematic review and meta-analysis of randomized controlled trials was conducted. Five databases (Medline, CINAHL, Science Direct, CAJ Full-text Database, and Cochrane databases) were searched for articles published from 2002 to 2012. The eligibility criteria were randomized trials and double-blind controlled trials of oral or injection drug therapy for CNLBP in subjects who were aged at least 18 years old, published in English or Chinese. Two independent reviewers extracted the data. Results: A total of 25 drug therapy trials were included. cyclo-oxygenase-2 (COX-2) nonsteroidal anti-inflammatory drugs (NSAIDs), tramadol, and opioids were commonly used. Only 5 trials studied the efficacy of adjuvant analgesics of antiepileptics (n = 1) and antidepressants (n = 4) for CNLBP. The standardized mean difference (SMD) for COX-2 NSAIDs in pain relief was -12.03 (95% confidence interval [CI]: -15.00 to -9.06). The SMD for tramadol in pain relief was -1.72 (95% CI: -3.45 to 0.01). As the 95% CI crossed 0, this effect size was not considered statistically significant. The SMD for the overall effects of opioids in pain relief was -5.18 (95% CI: -8.30 to -2.05). The SMD for the partial opioid agonist drug in pain relief was -7.46 (95% CI: -11.87 to -3.04). Limitations: The follow-up periods of these included trials in the meta-analysis ranged from 4 to 24 weeks. The difference of follow-up periods influenced how study outcomes were recorded. These included trials also had significant differences in patient selections. Some trials may actually include CNLBP patients with neuropathic pain, as not having focal neurological findings or signs does not mean that the pain is not neuropathic. Consequently, different pain conditions may influence patients who responded to the same drug and then influence pooled estimates of treatment effect size. Conclusion: This review endorses the use of COX-2 NSAIDs as the first-line drugs for CNLBP. Tramadol shows no statistically significant effect on pain relief, but has small effect sizes in improving functioning. Among included opioid therapy studies, the overall effects of opioids and the partial opioids agonist drug had statistically significant treatment effects in pain relief for CNLBP patients. Key words: NSAIDs, opioids, antidepressants, drug therapy, low back pain, systematic review, meta-analysis, randomized clinical trials

scholarly journals Ozone Therapy as a Treatment for Low Back Pain Secondary to Herniated Disc: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2012 ◽  
Vol 2;15 (2;3) ◽  
pp. E115-E129
Author(s):  
Erich T. Fonoff
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Pain Relief ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Low Back ◽  
Ozone Therapy ◽  
Randomized Controlled

Background: Low back pain (LBP) is one of the most common and important health problems affecting the population worldwide and remains mostly unsolved. Ozone therapy has emerged as an additional treatment method. Questions persist concerning its clinical efficacy. Objective: The purpose of our study was to evaluate the therapeutic results of percutaneous injection of ozone for low back pain secondary to disc herniation. Study Design: A systematic review and meta-analysis of randomized controlled trials. Methods: A comprehensive literature search was conducted using all electronic databases from 1966 through September 2011. The quality of individual articles was assessed based on the modified Cochrane review criteria for randomized trials and criteria from the Agency for Healthcare Research and Quality. Outcome Parameters: The outcome measure was short-term pain relief of at least 6 months or long-term pain relief of more than 6 months. Results: Eight observational studies were included in the systematic review and 4 randomized trials in the meta-analysis. The indicated level of evidence for long-term pain relief was II-3 for ozone therapy applied intradiscally and II-1 for ozone therapy applied paravertebrally. The grading of recommendation was 1C for intradiscal ozone therapy and 1B for paravertebral ozone therapy. Limitations: The main limitations of this review are the lack of precise diagnosis and the frequent use of mixed therapeutic agents. The meta-analysis included mainly active-control trials. No placebo-controlled trial was found. Conclusions: Ozone therapy appears to yield positive results and low morbidity rates when applied percutaneously for the treatment of chronic low back pain. Key words: Low back pain, oxygen-ozone, ozone therapy, chronic pain, failed back surgery syndrome.

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