The Effectiveness of Custom Foot Orthotics in Treating Chronic Low Back Pain: A Critically Appraised Topic

2016 ◽  
Vol 21 (1) ◽  
pp. 14-23
Author(s):  
Kathleen K. Hogan ◽  
William O. Perkins ◽  
Cameron J. Powden, ◽  
Matthew C. Hoch
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Usual Care ◽  
Chronic Low Back Pain ◽  
Included Study ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Low Back ◽  
Bottom Line ◽  
Quality Evidence

Clinical Scenario:Chronic low back pain is one of the most common causes of pain and disability. Currently, there is a need for more effective interventions to treat low back pain.Clinical Question:Does the use of custom foot orthotics improve self-reported measures of pain and function in adults with chronic low back pain?Summary of Key Findings:A comprehensive and systematic search was conducted for studies of level 2 evidence or higher that pertained to the clinical question. The search yielded 11 studies, of which one randomized control trial and two prospective cohorts fit the inclusion and exclusion criteria. The articles examined the effectiveness of custom foot orthotics in isolation compared with no treatment as well as custom foot orthotics in combination with usual care compared with usual care alone. The included studies all demonstrated that the use of custom foot orthotics reduce chronic low back pain after seven weeks of use. One included study was considered high-quality evidence while two were deemed low-quality evidence using the PEDro.Clinical Bottom Line:There is moderate evidence to support the use of custom foot orthotics to improve self-reported measures in adults with chronic low back pain after seven weeks of use.Strength of Recommendation:The Strength of Recommendation Taxonomy recommends a grade of B for consistent limited-quality patient-oriented evidence.

The Use of Breathing Exercises in the Treatment of Chronic, Nonspecific Low Back Pain

2017 ◽  
Vol 26 (5) ◽  
pp. 452-458 ◽  
Author(s):  
Barton E. Anderson ◽  
Kellie C. Huxel Bliven
Keyword(s):  
Quality Of Life ◽  
Low Back Pain ◽  
Back Pain ◽  
Lung Function ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Low Back ◽  
Bottom Line ◽  
Breathing Exercises

Clinical Scenario:Research has shown a link between poor core stability and chronic, nonspecific low back pain, with data to suggest that alterations in core muscle activation patterns, breathing patterns, lung function, and diaphragm mechanics may occur. Traditional treatment approaches for chronic, nonspecific low back pain focus on exercise and manual therapy interventions, however it is not clear whether breathing exercises are effective in treating back pain.Focused Clinical Question:In adults with chronic, nonspecific low back pain, are breathing exercises effective in reducing pain, improving respiratory function, and/or health related quality of life?Summary of Key Findings:Following a literature search, 3 studies were identified for inclusion in the review. All reviewed studies were critically appraised at level 2 evidence and reported improvements in either low back pain or quality of life following breathing program intervention.Clinical Bottom Line:Exercise programs were shown to be effective in improving lung function, reducing back pain, and improving quality of life. Breathing program frequencies ranged from daily to 2–3 times per week, with durations ranging from 4 to 8 weeks. Based on these results, athletic trainers and physical therapists caring for patients with chronic, nonspecific low back pain should consider the inclusion of breathing exercises for the treatment of back pain when such treatments align with the clinician’s own judgment and clinical expertise and the patient’s preferences and values.Strength of Recommendation:Grade B evidence exists to support the use of breathing exercises in the treatment of chronic, nonspecific low back pain.

scholarly journals Update of Markov Model on the Cost-effectiveness of Nonpharmacologic Interventions for Chronic Low Back Pain Compared to Usual Care

Spine ◽  
2020 ◽  
Vol 45 (19) ◽  
pp. 1383-1385
Author(s):  
Patricia M. Herman ◽  
Ryan K. McBain ◽  
Nicholas Broten ◽  
Ian D. Coulter
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cost Effectiveness ◽  
Markov Model ◽  
Usual Care ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
The Cost

scholarly journals Self-Administered Acupressure for Chronic Low Back Pain: A Randomized Controlled Pilot Trial

Pain Medicine ◽  
2019 ◽  
Vol 20 (12) ◽  
pp. 2588-2597 ◽  
Author(s):  
Susan Lynn Murphy ◽  
Richard Edmund Harris ◽  
Nahid Roonizi Keshavarzi ◽  
Suzanna Maria Zick
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Usual Care ◽  
Chronic Low Back Pain ◽  
Linear Models ◽  
Pilot Trial ◽  
Brief Pain Inventory ◽  
Poor Sleep ◽  
Low Back ◽  
Brief Fatigue Inventory

Abstract Objective Chronic low back pain (CLBP) is associated with fatigue, pain, poor sleep, and disability. Acupressure is a low-risk treatment option used to manage symptoms in other groups, but its efficacy, particularly on fatigue and sleep, is unknown in CLBP. This study examined preliminary effects of two types of self-administered acupressure (relaxing and stimulating) on fatigue, pain, sleep, and reported disability. Methods A randomized pilot trial was conducted (N = 67) in which participants were randomized into six weeks of relaxing acupressure, stimulating acupressure, or usual care. Fatigue was measured by the Brief Fatigue Inventory, pain was measured by the Brief Pain Inventory, sleep was measured by the Pittsburgh Sleep Quality Index, and reported disability was measured by the Roland Morris Scale. Results Baseline characteristics were similar across groups. An intent-to-treat analysis using general linear models showed positive improvement in pain in acupressure groups compared with usual care. Pain was reduced by 35–36% in the acupressure groups. Improvement in fatigue was also found in stimulating acupressure compared with usual care. Adverse events were minimal and related to application of too much pressure. Discussion Although this was a small study, acupressure demonstrated promising preliminary support of efficacy for pain and fatigue reduction in this population.

A Comparison of the Effects of 2 Types of Massage and Usual Care on Chronic Low Back Pain

2011 ◽  
Vol 155 (1) ◽  
pp. 1 ◽  
Author(s):  
Daniel C. Cherkin ◽  
Karen J. Sherman ◽  
Janet Kahn ◽  
Robert Wellman ◽  
Andrea J. Cook ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Usual Care ◽  
Chronic Low Back Pain ◽  
Low Back

scholarly journals Associates of Insomnia in People with Chronic Spinal Pain: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (14) ◽  
pp. 3175
Author(s):  
Thomas Bilterys ◽  
Carolie Siffain ◽  
Ina De Maeyer ◽  
Eveline Van Looveren ◽  
Olivier Mairesse ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Associated Factors ◽  
Meta Analysis ◽  
Spinal Pain ◽  
Low Back ◽  
Quality Evidence ◽  
Chronic Spinal Pain

Insomnia is a major problem in the chronic spinal pain (CSP) population and has a negative impact on health and well-being. While insomnia is commonly reported, underlying mechanisms explaining the relation between sleep and pain are still not fully understood. Additionally, no reviews regarding the prevention of insomnia and/or associated factors in people with CSP are currently available. To gain a better understanding of the occurrence of insomnia and associated factors in this population, we conducted a systematic review of the literature exploring associates for insomnia in people with CSP in PubMed, Web of Science and Embase. Three independent reviewers extracted the data and performed the quality assessment. A meta-analysis was conducted for every potential associate presented in at least two studies. A total of 13 studies were found eligible, which together identified 25 different potential associates of insomnia in 24,817 people with CSP. Twelve studies had a cross-sectional design. Moderate-quality evidence showed a significantly higher rate for insomnia when one of the following factors was present: high pain intensity, anxiety and depression. Low-quality evidence showed increased odds for insomnia when one of the following factors was present: female sex, performing no professional activities and physical/musculoskeletal comorbidities. Higher healthcare use was also significantly related to the presence of insomnia. One study showed a strong association between high levels of pain catastrophizing and insomnia in people with chronic neck pain. Last, reduced odds for insomnia were found in physically active people with chronic low back pain compared to inactive people with chronic low back pain. This review provides an overview of the available literature regarding potential associates of insomnia in people with CSP. Several significant associates of insomnia were identified. These findings can be helpful to gain a better understanding of the characteristics and potential origin of insomnia in people witch CSP, to identify people with CSP who are (less) likely to have insomnia and to determine directions of future research in this area.

scholarly journals Are Nonpharmacologic Interventions for Chronic Low Back Pain More Cost Effective Than Usual Care? Proof of Concept Results From a Markov Model

Spine ◽  
2019 ◽  
Vol 44 (20) ◽  
pp. 1456-1464 ◽  
Author(s):  
Patricia M. Herman ◽  
Tara A. Lavelle ◽  
Melony E. Sorbero ◽  
Eric L. Hurwitz ◽  
Ian D. Coulter
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Markov Model ◽  
Usual Care ◽  
Chronic Low Back Pain ◽  
Cost Effective ◽  
Low Back ◽  
Proof Of Concept
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