scholarly journals Effectiveness of treatments for acute and subacute mechanical non-specific low back pain: a systematic review with network meta-analysis

2021 ◽  
pp. bjsports-2020-103596
Author(s):  
Silvia Gianola ◽  
Silvia Bargeri ◽  
Gabriele Del Castillo ◽  
Davide Corbetta ◽  
Andrea Turolla ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Muscle Relaxants ◽  
Low Back ◽  
Eligibility Criteria ◽  
Experienced Pain ◽  
Inflammatory Drugs

ObjectiveTo assess the effectiveness of interventions for acute and subacute non-specific low back pain (NS-LBP) based on pain and disability outcomes.DesignA systematic review of the literature with network meta-analysis.Data sourcesMedline, Embase and CENTRAL databases were searched from inception until 17 October 2020.Eligibility criteria for selecting studiesRandomised clinical trials (RCTs) involving adults with NS-LBP who experienced pain for less than 6 weeks (acute) or between 6 and 12 weeks (subacute).ResultsForty-six RCTs (n=8765) were included; risk of bias was low in 9 trials (19.6%), unclear in 20 (43.5%), and high in 17 (36.9%). At immediate-term follow-up, for pain decrease, the most efficacious treatments against an inert therapy were: exercise (standardised mean difference (SMD) −1.40; 95% confidence interval (CI) −2.41 to –0.40), heat wrap (SMD −1.38; 95% CI −2.60 to –0.17), opioids (SMD −0.86; 95% CI −1.62 to –0.10), manual therapy (SMD −0.72; 95% CI −1.40 to –0.04) and non-steroidal anti-inflammatory drugs (NSAIDs) (SMD −0.53; 95% CI −0.97 to –0.09). Similar findings were confirmed for disability reduction in non-pharmacological and pharmacological networks, including muscle relaxants (SMD -0.24; 95% CI -0.43 to -0.04). Mild or moderate adverse events were reported in the opioids (65.7%), NSAIDs (54.3%) and steroids (46.9%) trial arms.ConclusionWith uncertainty of evidence, NS-LBP should be managed with non-pharmacological treatments which seem to mitigate pain and disability at immediate-term. Among pharmacological interventions, NSAIDs and muscle relaxants appear to offer the best harm–benefit balance.

scholarly journals Efficacy of Auricular Acupressure for Chronic Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Li-Hua Yang ◽  
Pei-Bei Duan ◽  
Qing-Mei Hou ◽  
Shi-Zheng Du ◽  
Jin-Fang Sun ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Low Back ◽  
Randomized Controlled ◽  
Auricular Acupressure

Objectives. To identify the efficacy of auricular acupressure on pain and disability for chronic LBP by systematic review.Methods. A search of randomized controlled trials was conducted in four English medical electronic databases and three Chinese databases. Two reviewers independently retrieved related studies, assessed the methodological quality, and extracted data with a standardized data form. Meta-analyses were performed using all time-points meta-analysis.Results. A total of 7 trials met the inclusion criteria, of which 4 had the low risk of bias. The findings of this study showed that, for the immediate effect, auricular acupressure had large, significant effects in improving pain within 12 weeks. As for the follow-up effect, the pooled estimates also showed promising effect at 4-week follow-up after 4-week intervention (standardized mean difference = −1.13, 95% CI (-1.70,-0.56),P<0.001). But, for the disability level, the therapeutic effect was not significant (mean difference = −1.99, 95% CI (-4.93, 0.95),P=0.18). No serious adverse effects were recorded.Conclusions. The encouraging evidence of this study indicates that it is recommended to provide auricular acupressure to patients with chronic low back pain. However, a more accurate estimate of the effect will require further rigorously designed large-scale RCTs on chronic LBP for improving pain and disability.

Efficacy and tolerability of muscle relaxants for low back pain: Systematic review and meta-analysis

2016 ◽  
Vol 21 (2) ◽  
pp. 228-237 ◽  
Author(s):  
C. Abdel Shaheed ◽  
C.G. Maher ◽  
K.A. Williams ◽  
A.J. McLachlan
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Muscle Relaxants ◽  
Low Back

scholarly journals Do people with low back pain walk differently? A systematic review and meta-analysis

2021 ◽  
Author(s):  
Jo Armour Smith ◽  
Heidi Stabbert ◽  
Jennifer J Bagwell ◽  
Hsiang-Ling Teng ◽  
Vernie Wade ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Meta Analysis ◽  
Reporting Quality ◽  
Healthy Controls ◽  
Low Back ◽  
Eligibility Criteria ◽  
Walking Gait

Objective To identify differences in biomechanics during gait in individuals with acute and persistent low back pain compared with back-healthy controls. Design Systematic review Data Sources A search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Eligibility criteria Studies were included if they reported biomechanical characteristics of individuals with and without low back pain during steady-state or perturbed walking and running. Biomechanical data included spatiotemporal, kinematic, kinetic, and electromyography variables. The reporting quality and potential for bias of each study was assessed. Data were pooled where possible to compare the standardized mean differences (SMD) between groups. Results Ninety-seven studies were included. Two studies investigated acute pain and the rest investigated persistent pain. Eight studies investigated running gait. 20% of studies had high reporting quality/low risk of bias. In comparison with back-healthy controls, individuals with persistent low back pain walked more slowly (SMD -0.59 [95% CI -0.77 to -0.42]) and with shorter stride length (-0.38 [-0.60 to -0.16]). There were no differences in the amplitude of motion in the thoracic or lumbar spine, pelvis, or hips in individuals with LBP. During walking, coordination of motion between the thorax and the lumbar spine/pelvis was significantly more in-phase in the LBP groups (-0.60 [-0.90 to -0-.30]), and individuals with LBP exhibited greater amplitude of activation in the paraspinal muscles (0.52 [0.23 to 0.80]). Summary/Conclusion There is moderate to strong evidence that individuals with persistent LBP demonstrate impairments in walking gait compared with back-healthy controls.

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

2020 ◽  
Vol 90 ◽  
pp. 104177 ◽  
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

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

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

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

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.

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