What is usual care for low back pain? A systematic review of health care provided to patients with low back pain in family practice and emergency departments

Objective: To assess the effectiveness of acupuncture for non-specific low back pain (NSLBP) through systematic review of published randomised controlled trials (RCTs). Methods: Studies were identified in electronic databases from their inception to February 2018, and were grouped according to the control interventions. The outcomes of interest were pain intensity and disability. Methodological quality was evaluated using the Cochrane risk-of-bias criteria and the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) checklist. The review was reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: 25 trials (n=7587 participants) were identified and included in a meta-analysis. The results showed that acupuncture was more effective at inducing pain relief than: no treatment (standardised mean difference (SMD) −0.69, 95% CI −0.99 to −0.38); sham acupuncture in the immediate term (SMD −0.33, 95% CI −0.49 to −0.18), short term (SMD −0.47, 95% CI −0.77 to −0.17), and intermediate term (SMD −0.17, 95% CI −0.28 to −0.05); and usual care in the short term (SMD −1.07, 95% CI −1.81 to −0.33) and intermediate term (SMD −0.43, 95% CI −0.77 to −0.10). Also, adjunctive acupuncture with usual care was more effective than usual care alone at all time points studied. With regard to functional improvement, the analysis showed a significant difference between acupuncture and no treatment (SMD −0.94, 95% CI −1.57 to −0.30), whereas the other control therapies could not be assessed. Conclusion: We draw a cautious conclusion that acupuncture appears to be effective for NSLBP and that acupuncture may be an important supplement to usual care in the management of NSLBP.

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The association between depressive symptoms or depression and health outcomes in adults with low back pain with or without radiculopathy: protocol of a systematic review

Systematic Reviews ◽

10.1186/s13643-019-1192-4 ◽

2019 ◽

Vol 8 (1) ◽

Author(s):

Jessica J. Wong ◽

Andrea C. Tricco ◽

Pierre Côté ◽

Laura C. Rosella

Keyword(s):

Systematic Review ◽

Health Care ◽

Low Back Pain ◽

Back Pain ◽

Depressive Symptoms ◽

Health Outcomes ◽

Risk Of Bias ◽

Considerable Proportion ◽

Low Back ◽

The Impact

Abstract Background A considerable proportion of adults with low back pain (LBP) suffer from depressive symptoms or depression. Those with depressive symptoms or depression may be at risk of poorer LBP recovery and require more health care. Understanding the role of prognostic factors for LBP is critically important to guide management and health services delivery. Our objective is to conduct a systematic review to assess the association between depressive symptoms or depression and health outcomes in adults with LBP with or without radiculopathy. Methods Electronic databases including MEDLINE, Embase, CINAHL, and PsycINFO will be searched from inception to April 2019 to identify relevant studies. Additional citations will be identified by searching reference lists of included studies and related systematic reviews. Cohort and case-control studies assessing the association between depressive symptoms/depression and health outcomes in adults aged 16 years and older with LBP with or without radiculopathy will be included. The following will be included: depressive symptoms as measured on standardized questionnaires (e.g., Center for Epidemiologic Studies Depression Scale, Beck Depression Index), and depression as standardized diagnoses (e.g., International Classification of Diseases codes) or self-reported depression diagnosis on standardized questionnaires. Outcomes of interest are standardized measures for pain, disability, overall health status, satisfaction with care, and health care utilization. These are informed by core outcome domains that international expert panels consider important for LBP research. Pairs of reviewers will screen articles retrieved from the search, extract data, and assess risk of bias using the Risk Of Bias In Non-randomized Studies-of Exposures (ROBINS-E) tool. Reviewers will use these criteria to inform their judgment on the internal validity of studies (e.g., low, moderate, or high risk of bias). If studies are deemed homogeneous, a random effects meta-analysis on the association between depressive symptoms and health outcomes will be performed. The results of the included studies will be descriptively outlined if studies are deemed heterogeneous. Discussion The impact of depressive symptoms and depression on health- and health care-related outcomes for LBP with or without radiculopathy will be assessed and quantified. Findings of this systematic review will advance our understanding of LBP prognosis, and guide decision-making and improve quality of care for adults with LBP. Systematic review registration PROSPERO CRD42019130047

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Low back pain and its related risk factors in health care providers at hospitals: A systematic review

Annals of Medicine and Surgery ◽

10.1016/j.amsu.2021.102903 ◽

2021 ◽

pp. 102903

Author(s):

Bareza Rezaei ◽

Elahe Mousavi ◽

Bahram Heshmati ◽

Shaphagh Asadi

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Health Care ◽

Low Back Pain ◽

Back Pain ◽

Health Care Providers ◽

Low Back ◽

Care Providers ◽

Related Risk

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The Efficacy and Effectiveness of Education for Preventing and Treating Non-Specific Low Back Pain in the Hispanic Cultural Setting: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19020825 ◽

2022 ◽

Vol 19 (2) ◽

pp. 825

Author(s):

Francisco M. Kovacs ◽

Natalia Burgos-Alonso ◽

Ana María Martín-Nogueras ◽

Jesús Seco-Calvo

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Usual Care ◽

Randomized Clinical Trials ◽

School Setting ◽

Active Management ◽

Low Back ◽

Education Programs ◽

Cultural Setting

A systematic review was conducted to assess the efficacy and effectiveness of education programs to prevent and treat low back pain (LBP) in the Hispanic cultural setting. Electronic and manual searches identified 1148 unique references. Nine randomized clinical trials (RCTs) were included in this review. Methodological quality assessment and data extraction followed the recommendations from the Cochrane Back Pain Review Group. Education programs which were assessed focused on active management (3 studies), postural hygiene (7), exercise (4) and pain neurophysiology (1). Comparators were no intervention, usual care, exercise, other types of education, and different combinations of these procedures. Five RCTs had a low risk of bias. Results show that: (a) education programs in the school setting can transmit potentially useful knowledge for LBP prevention and (b) education programs for patients with LBP improve the outcomes of usual care, especially in terms of disability. Education on pain neurophysiology improves the results of education on exercise, and education on active management is more effective than “sham” education and education on postural hygiene. Future studies should assess the comparative or summatory effects of education on exercise, education on pain neurophysiology and education on active management, as well as explore their efficiency.

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