scholarly journals Spinal manipulative therapy and acupuncture for chronic low back pain: a systematic review and meta-analysis of RCTs

2021 ◽  
Author(s):  
Ting Yue ◽  
Jingjing Li ◽  
Jiaman Yang ◽  
Dehui Fan
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Adverse Events ◽  
Chronic Low Back Pain ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Low Back ◽  
Quality Of Evidence ◽  
Moderate Quality

Abstract Background Spinal manipulation therapy (SMT) and acupuncture are commonly used for low back pain (LBP) among complementary and alternative therapies. However, it remains unclear which of the two therapies is more effective for LBP. Therefore, the purpose of this meta-analysis was to evaluate the effectiveness of SMT and acupuncture on LBP. Methods Four electronic databases were searched for randomized controlled trials (all years until July 2021), including PubMed, Embase, Web of Science, and Cochrane Library. Two reviewers independently abstracted data, assessed risk of bias, and rated the quality of evidence. The primary outcome was pain; secondary outcomes included functional status and adverse events. Review Manager 5.3 software and Stata 12.0 were used for all statistical analyses. Results 9 RCTs with a total of 714 participants were identified, who were on average middle aged (39-60 years) without signs of radiating pain. These trials included patients with mild to moderate pain. Overall, moderate quality of evidence suggested that SMT had better effects for pain relief (MD: 0.32, 95%CI: 0.09 to 0.55, I2=34%) and similar effects in function (MD: 0.24, 95%CI: -0.45 to 0.94, I2=21%) when compared to acupuncture. Moderate quality of evidence showed SMT reduced pain better than acupuncture at month 2 (MD: 0.61, 95%CI: 0.08 to 1.14, I2=0%) and at month 12 (MD: 1.02, 95%CI: 0.28 to 1.75, I2=42%). In addition, Low quality of evidence showed SMT may provide better improvement in pain at month 3 (MD: 0.74, 95%CI: 0.09 to 1.39, I2=42%) and in function at month 4 (MD: 3.50, 95%CI: 0.71 to 6.29). Adverse events associated with SMT and acupuncture were rare and mild. Conclusions SMT showed better effects than acupuncture for chronic low back pain, while SMT and acupuncture had similar effects in functional improvement. Although SMT and acupuncture were tolerable and safe, patients should be informed about the potential risks of adverse events before starting therapy.

scholarly journals Physical Activity for the Treatment of Chronic Low Back Pain in Elderly Patients: A Systematic Review

2020 ◽  
Vol 9 (4) ◽  
pp. 1023 ◽  
Author(s):  
Gianluca Vadalà ◽  
Fabrizio Russo ◽  
Sergio De Salvatore ◽  
Gabriele Cortina ◽  
Erika Albo ◽  
...  
Keyword(s):  
Physical Activity ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Low Back ◽  
Quality Of Evidence ◽  
Randomized Controlled

Chronic low back pain (CLBP) affects nearly 20–25% of the population older than 65 years, and it is currently the main cause of disability both in the developed and developing countries. It is crucial to reach an optimal management of this condition in older patients to improve their quality of life. This review evaluates the effectiveness of physical activity (PA) to improve disability and pain in older people with non-specific CLBP. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to improve the reporting of the review. Individual risk of bias of single studies was assessed using Rob 2 tool and ROBINS-I tool. The quality of evidence assessment was performed using GRADE analysis only in articles that presents full data. The articles were searched in different web portals (Medline, Scopus, CINAHL, EMBASE, and CENTRAL). All the articles reported respect the following inclusion criteria: patients > 65 years old who underwent physical activities for the treatment of CLBP. A total of 12 studies were included: 7 randomized controlled trials (RCT), 3 non-randomized controlled trials (NRCT), 1 pre and post intervention study (PPIS), and 1 case series (CS). The studies showed high heterogeneity in terms of study design, interventions, and outcome variables. In general, post-treatment data showed a trend in the improvement for disability and pain. However, considering the low quality of evidence of the studies, the high risk of bias, the languages limitations, the lack of significant results of some studies, and the lack of literature on this argument, further studies are necessary to improve the evidences on the topic.

Acupuncture for Chronic Low Back Pain in Long-Term Follow-Up: A Meta-Analysis of 13 Randomized Controlled Trials

2013 ◽  
Vol 41 (01) ◽  
pp. 1-19 ◽  
Author(s):  
Mai Xu ◽  
Shi Yan ◽  
Xu Yin ◽  
Xiuyang Li ◽  
Shuguang Gao ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Meta Analysis ◽  
Sham Acupuncture ◽  
Controlled Trials ◽  
Low Back ◽  
Randomized Controlled ◽  
Nonspecific Effects

Chronic low back pain is one of the most common reasons that people seek medical treatment, and the consequent disability creates a great financial burden on individuals and society. The etiology of chronic low back pain is not clear, which means it is often refractory to treatment. Acupuncture has been reported to be effective in providing symptomatic relief of chronic low back pain. However, it is not known whether the effects of acupuncture are due to the needling itself or nonspecific effects arising from the manipulation. To determine the effectiveness of acupuncture therapy, a meta-analysis was performed to compare acupuncture with sham acupuncture and other treatments. Overall, 2678 patients were identified from thirteen randomized controlled trials. The meta-analysis was performed by a random model (Cohen's test), using the I-square test for heterogeneity and Begg's test to assess for publication bias. Clinical outcomes were evaluated by pain intensity, disability, spinal flexion, and quality of life. Compared with no treatment, acupuncture achieved better outcomes in terms of pain relief, disability recovery and better quality of life, but these effects were not observed when compared to sham acupuncture. Acupuncture achieved better outcomes when compared with other treatments. No publication bias was detected. Acupuncture is an effective treatment for chronic low back pain, but this effect is likely to be produced by the nonspecific effects of manipulation.

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.

scholarly journals Posterior-Chain Resistance Training Compared to General Exercise and Walking Programmes for the Treatment of Chronic Low Back Pain in the General Population: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Nicholas Tataryn ◽  
Vini Simas ◽  
Tailah Catterall ◽  
James Furness ◽  
Justin W. L. Keogh
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Resistance Training ◽  
Muscle Strength ◽  
Adverse Events ◽  
Muscular Strength ◽  
Meta Analysis ◽  
Low Back ◽  
Pain Level ◽  
General Exercise

Abstract Background While chronic exercise training has been demonstrated to be an effective non-pharmacological treatment for chronic low back pain (CLBP), there has been a relative lack of evidence or clinical guidelines for whether a posterior chain resistance training programme provides any benefits over general exercise (GE). Objectives To determine if chronic posterior chain resistance training (PCRT), defined as exercise programmes of ≥6 weeks duration focused on the thoracic, lumbar and hip extensor musculature, is more effective than GE in improving pain, level of disability, muscular strength and the number of adverse events in recreationally active and sedentary individuals with CLBP. Methods Four electronic databases were systematically searched from 25 September 2019 until 30 August 2020. Using the Joanna Briggs Institute (JBI) Critical Appraisal Tools checklist for randomized controlled trials (RCTs), articles were critically appraised and compared against the inclusion/exclusion criteria. Standardized mean difference (SMD), risk difference (RD) and confidence interval (CI) were calculated using Review Manager 5.3. Results Eight articles were included, with a total of 408 participants (203 PCRT, 205 GE). Both PCRT and GE were effective in improving a number of CLBP-related outcomes, but these effects were often significantly greater in PCRT than GE, especially with greater training durations (i.e. 12–16 weeks compared to 6–8 weeks). Specifically, when compared to GE, PCRT demonstrated a greater reduction in pain (SMD = − 0.61 (95% CI − 1.21 to 0.00), p = 0.05; I2 = 74%) and level of disability (SMD = − 0.53 (95% CI − 0.97 to − 0.09), p = 0.02; I2 = 52%), as well as a greater increase in muscle strength (SMD = 0.67 (95% CI 0.21 to 1.13), p = 0.004; I2 = 0%). No differences in the number of adverse events were reported between PCRT and GE (RD = − 0.02 (95% CI − 0.10 to 0.05), p = 0.57; I2 = 72%). Conclusion Results of the meta-analysis indicated that 12–16 weeks of PCRT had a statistically significantly greater effect than GE on pain, level of disability and muscular strength, with no significant difference in the number of adverse events for recreationally active and sedentary patients with CLBP. Clinicians should strongly consider utilizing PCRT interventions for 12–16 weeks with patients with CLBP to maximize their improvements in pain, disability and muscle strength. Future research should focus on comparing the efficacy and adverse events associated with specific PCRT exercise training and movement patterns (i.e. deadlift, hip lift) in treating this population. Trial registration PROSPERO CRD42020155700.

Quality of Life in Chronic Low Back Pain: A Comparison with Fibromyalgia and the General Population

2003 ◽  
Vol 11 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Olle Hägg ◽  
Carol Burckhardt ◽  
Peter Fritzell ◽  
Anders Nordwall
Keyword(s):  
Quality Of Life ◽  
Low Back Pain ◽  
Back Pain ◽  
General Population ◽  
Chronic Low Back Pain ◽  
Low Back

scholarly journals Intervertebral disc therapies for non-specific chronic low back pain: a systematic review and meta-analysis

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110280
Author(s):  
Camille Daste ◽  
Stéphanie Laclau ◽  
Margaux Boisson ◽  
François Segretin ◽  
Antoine Feydy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Intervertebral Disc ◽  
Chronic Low Back Pain ◽  
Meta Analysis ◽  
Activity Limitations ◽  
Low Back ◽  
Short Term

Objectives: We aim to evaluate the benefits and harms of intervertebral disc therapies (IDTs) in people with non-specific chronic low back pain (NScLBP). Methods: We conducted a systematic review and meta-analysis of randomized trials of IDTs versus placebo interventions, active comparators or usual care. EMBASE, MEDLINE, CENTRAL and CINHAL databases and conference abstracts were searched from inception to June 2020. Two independent investigators extracted data. The primary outcome was LBP intensity at short term (1 week–3 months), intermediate term (3–6 months) and long term (after 6 months). Results: Of 18 eligible trials (among 1396 citations), five assessed glucocorticoids (GCs) IDTs and were included in a quantitative synthesis; 13 assessed other products including etanercept ( n = 2), tocilizumab ( n = 1), methylene blue ( n = 2), ozone ( n = 2), chymopapaine ( n = 1), glycerol ( n = 1), stem cells ( n = 1), platelet-rich plasma ( n = 1) and recombinant human growth and differentiation factor-5 ( n = 2), and were included in a narrative synthesis. Standardized mean differences (95% CI) for GC IDTs for LBP intensity and activity limitations were −1.33 (−2.34; −0.32) and −0.76 (−1.85; 0.34) at short term, −2.22 (−5.34; 0.90) and −1.60 (−3.51; 0.32) at intermediate term and −1.11 (−2.91; 0.70) and −0.63 (−1.68; 0.42) at long term, respectively. Odds ratios (95% CI) for serious and minor adverse events with GC IDTs were 1.09 (0.25; 4.65) and 0.97 (0.49; 1.91). Conclusion: GC IDTs are associated with a reduction in LBP intensity at short term in people with NScLBP. Positive effects are not sustained. IDTs have no effect on activity limitations. Our conclusions are limited by high heterogeneity and a limited methodological quality across studies. Registration PROSPERO: CRD42019106336.

scholarly journals Occupational Related Upper and Low Back Pain Among Working Population of Ethiopia: Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Dechasa Adare Mengistu ◽  
Yohannes Mulugeta Demmu ◽  
Addisu Alemu
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Well Being ◽  
Boolean Logic ◽  
Cochrane Library ◽  
Low Back ◽  
Working Population ◽  
Pooled Prevalence

Abstract Background: Back pains, such as low and upper back pains are among the most common musculoskeletal conditions that can cause major public health and socioeconomic problems. Back pain is one of the leading causes of disability that reduces worker performance and well-being and increases absence from work, which can cause an enormous economic burden. In developing countries, particularly in Ethiopia, there is no adequate evidence on the overall prevalence of occupational-related low and upper back pains and remain less prioritized and empirically unrepresented. Therefore, this study aimed to determine the prevalence of occupational-related low and upper back pains among the working population of Ethiopia.Methods: This systematic review and meta-analysis considered studies conducted in Ethiopia, written in English, and published from 2017-2020. Articles were searched from nine electronic databases (Web of Science, SCOPUS, PubMed, Google Scholar, CINAHL, Cochrane Library, African Index Medicus, African Journals Online database and Science Direct) using a combination of Boolean logic operators, Medical Subject Headings and main keywords. The quality assessment of the articles was performed using Joanna Briggs Institute Critical Appraisal tools to determine the relevance of the articles to the study. A random effects model was used to estimate the pooled prevalence, the 95% confidence interval, and the degree of heterogeneity among the included studies. Sensitivity analyzes were performed to identify the influence of outliers and to identify sources of heterogeneity.Results: Of the 1,114 studies identified from the included databases, 20 studies were included in the systematic review and meta-analysis. The pooled prevalence of occupational-related upper and low back pain in the previous year was 27.1% [95% CI: 18.4, 37.9] and 54.2% [95% CI: 48.2, 60.0], respectively. Based on a subgroup analysis by publication year, study population and countries where the studies are conducted, the prevalence of upper back pain was 43.8% [95% CI: 39.3, 47.7], 34.7% [95% CI: 33.1, 36.2], and 36.2% [95% CI: 33.6, 39.0], respectively, while the prevalence of low back pain was 61.8% [95% CI: 58.9, 64.6], 52.8% [95% CI: 51.3, 54.3] and 55.2% [95% CI: 51.4, 59.0], respectively.Conclusions: This systematic review and meta-analysis found that 54.2% of the included study participants experienced low back pain in the previous year, while 27.1% experienced upper back pain. These problems may be reduced by considering proper observation of the principles of ergonomics in the workplace, and performing physical exercises on a regular basis.

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