Prevention strategies to reduce future impact of low back pain: a systematic review and meta-analysis

ObjectiveTo evaluate the evidence from randomised controlled trials (RCTs) on the effectiveness of prevention strategies to reduce future impact of low back pain (LBP), where impact is measured by LBP intensity and associated disability.DesignSystematic review with meta-analysis.Data sourcesMEDLINE, Embase, CINAHL, PEDro and The Cochrane (CENTRAL) databases from inception to 22 October 2018.Eligibility criteriaRCTs evaluating any intervention aiming to prevent future impact of LBP, reporting an outcome measure of LBP intensity and/or disability measured at least 3 months post-randomisation, and the intervention group must be compared with a group that received no intervention/placebo or minimal intervention. Trials restricting recruitment to participants with current LBP were excluded.Results27 published reports of 25 different trials including a total of 8341 participants fulfilled the inclusion criteria. The pooled results, from three RCTs (612 participants), found moderate-quality evidence that an exercise programme can prevent future LBP intensity (mean difference (MD) −4.50; 95% CI −7.26 to −1.74), and from 4 RCTs (471 participants) that an exercise and education programme can prevent future disability due to LBP (MD −6.28; 95% CI −9.51 to −3.06). It is uncertain whether prevention programmes improve future quality of life (QoL) and workability due to the overall low-quality and very low-quality available evidence.ConclusionsThis review provides moderate-quality evidence that an exercise programme, and a programme combining exercise and education, are effective to reduce future LBP intensity and associated disability. It is uncertain whether prevention programmes can improve future QoL and workability. Further high-quality RCTs evaluating prevention programmes aiming to reduce future impact of LBP are needed.

Download Full-text

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

Journal of Clinical Medicine ◽

10.3390/jcm10143175 ◽

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.

Download Full-text

How common is imaging for low back pain in primary and emergency care? Systematic review and meta-analysis of over 4 million imaging requests across 21 years

British Journal of Sports Medicine ◽

10.1136/bjsports-2018-100087 ◽

2019 ◽

Vol 54 (11) ◽

pp. 642-651 ◽

Cited By ~ 7

Author(s):

Aron Downie ◽

Mark Hancock ◽

Hazel Jenkins ◽

Rachelle Buchbinder ◽

Ian Harris ◽

...

Keyword(s):

Primary Care ◽

Low Back Pain ◽

Back Pain ◽

Emergency Care ◽

Meta Analysis ◽

Relative Increase ◽

Low Back ◽

Eligibility Criteria ◽

Moderate Quality ◽

Quality Evidence

ObjectivesTo (1) estimate the proportion of patients seeking care for low back pain (LBP) who are imaged and (2) explore trends in the proportion of patients who received diagnostic imaging over time. We also examined the effect of study-level factors on estimates of imaging proportion.Data sourcesElectronic searches of MEDLINE, Embase and CINAHL databases from January 1995 to December 2017.Eligibility criteria for selecting studiesObservational designs and controlled trials that reported imaging for patients presenting to primary care or emergency care for LBP. We assessed study quality and calculated pooled proportions by care setting and imaging type, with strength of evidence assessed using the GRADE system.Results45 studies were included. They represented 19 451 749 consultations for LBP that had resulted in 4 343 919 imaging requests/events over 21 years. Primary care: moderate quality evidence that simple imaging proportion was 16.3% (95% CI 12.6% to 21.1%) and complex imaging was 9.2% (95% CI 6.2% to 13.5%). For any imaging, the pooled proportion was 24.8% (95% CI 19.3%to 31.1%). Emergency care: moderate quality evidence that simple imaging proportion was 26.1% (95% CI 18.2% to 35.8%) and high-quality evidence that complex imaging proportion was 8.2% (95% CI 4.4% to 15.6%). For any imaging, the pooled proportion was 35.6% (95% CI 29.8% to 41.8%). Complex imaging increased from 7.4% (95% CI 5.7% to 9.6%) for imaging requested in 1995 to 11.4% (95% CI 9.6% to 13.5%) in 2015 (relative increase of 53.5%). Between-study variability in imaging proportions was only partially explained by study-level characteristics; there were insufficient data to comment on some prespecified study-level factors.Summary/conclusionOne in four patients who presented to primary care with LBP received imaging as did one in three who presented to the emergency department. The rate of complex imaging appears to have increased over 21 years despite guideline advice and education campaigns.Trial registration numberCRD42016041987.

Download Full-text

Faculty of 1000 evaluation for A Systematic Review and Meta-analysis of Yoga for Low Back Pain.

F1000 - Post-publication peer review of the biomedical literature ◽

10.3410/f.717969647.793474478 ◽

2013 ◽

Author(s):

Rajesh Gupta

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Meta Analysis ◽

Low Back

Download Full-text

Faculty Opinions recommendation of A systematic review and meta-analysis of yoga for low back pain.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717969647.793470077 ◽

2013 ◽

Author(s):

Arun Bhaskar

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Meta Analysis ◽

Low Back

Download Full-text

Efficacy of conservative therapy in older people with nonspecific low back pain: A systematic review with meta-analysis and GRADE recommendations

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2020.104177 ◽

2020 ◽

Vol 90 ◽

pp. 104177 ◽

Cited By ~ 2

Author(s):

Lorena K.B. Amaral ◽

Mateus B. Souza ◽

Mariana G.M. Campos ◽

Vanessa A. Mendonça ◽

Alessandra Bastone ◽

...

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Older People ◽

Conservative Therapy ◽

Meta Analysis ◽

Low Back

Download Full-text

Comparisons of hamstring flexibility between individuals with and without low back pain: systematic review with meta-analysis

Physiotherapy Theory and Practice ◽

10.1080/09593985.2019.1639868 ◽

2019 ◽

pp. 1-24

Author(s):

Masataka Hori ◽

Hiroyuki Hasegawa ◽

Hiroshi Takasaki

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Meta Analysis ◽

Low Back ◽

Hamstring Flexibility

Download Full-text

Tibetan herbal pain-relieving plaster for low back pain: A systematic review and meta-analysis

Biomedicine & Pharmacotherapy ◽

10.1016/j.biopha.2021.111727 ◽

2021 ◽

Vol 140 ◽

pp. 111727

Author(s):

Mingxiao Yang ◽

Susan Q. Li ◽

Colleen M. Smith ◽

Yi Lily Zhang ◽

Ting Bao ◽

...

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Meta Analysis ◽

Low Back

Download Full-text

Effects of low back pain on balance performance in elderly people: a systematic review and meta-analysis

European Review of Aging and Physical Activity ◽

10.1186/s11556-021-00263-z ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Le Ge ◽

Chuhuai Wang ◽

Haohan Zhou ◽

Qiuhua Yu ◽

Xin Li

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Elderly People ◽

Meta Analysis ◽

Cochrane Library ◽

Original Research ◽

Low Back ◽

Centre Of Pressure ◽

Balance Performance

Abstract Background Research suggests that individuals with low back pain (LBP) may have poorer motor control compared to their healthy counterparts. However, the sample population of almost 90% of related articles are young and middle-aged people. There is still a lack of a systematic review about the balance performance of elderly people with low back pain. This study aimed to conduct a systematic review and meta-analysis to understand the effects of LBP on balance performance in elderly people. Methods This systematic review and meta-analysis included a comprehensive search of PubMed, Embase, and Cochrane Library databases for full-text articles published before January 2020. We included the articles that 1) investigated the elderly people with LBP; 2) assessed balance performance with any quantifiable clinical assessment or measurement tool and during static or dynamic activity; 3) were original research. Two independent reviewers screened the relevant articles, and disagreements were resolved by a third reviewer. Results Thirteen case-control studies comparing balance performance parameters between LBP and healthy subjects were included. The experimental group (LBP group) was associated with significantly larger area of centre of pressure movement (P < 0.001), higher velocity of centre of pressure sway in the anteroposterior and mediolateral directions (P = 0.01 and P = 0.02, respectively), longer path length in the anteroposterior direction (P < 0.001), slower walking speed (P = 0.05), and longer timed up and go test time (P = 0.004) than the control group. Conclusion The results showed that balance performance was impaired in elderly people with LBP. We should pay more attention to the balance control of elderly people with LBP.

Download Full-text