scholarly journals Tuina for Chronic Non-specific Low Back Pain: a systematic review and meta-analysis (Preprint)

2020 ◽  
Author(s):  
Juan Yang ◽  
Jeffrey S. Brault ◽  
Mark A. Jensen ◽  
Alexander Do ◽  
Qingyu Ma ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
World Health ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Low Back ◽  
Study Results ◽  
The Impact

BACKGROUND Chronic non-specific low back pain (CNLBP) is one of the most common complex conditions strongly associated with high rates of disability. Even though many studies on Tuina for CNLBP patients reported, until now, there is no study synthesize the currently available publications. OBJECTIVE This protocol aims to provide authors the guideline used to systematically review the effect and safety of Tuina therapy for treating patients with CNLBP. METHODS An electronic literature search will be conducted in the following databases: MEDLINE, Embase, Cochrane Library, Springer, Web of Science, Scopus, World Health Organization International Clinical Trials Registry Platform (ICTRP), the Chinese Biomedical Literature Database (CBM), the China National Knowledge Infrastructure (CNKI), Wan-fang database (WAN FANG), Chinese Biomedical Literature Databases (CBM), and Chinese Scientific Journal Database VIP Information (VIP). From database inception to Dec 30, 2019, English, and Chinese language only. Randomized controlled trials (RCTs) involving Tuina for patients with CNLBP will be reviewed. The primary outcomes of the study are an improvement of pain, analgesic medication reduction, improvement of functional disability, and degree of satisfaction with the intervention. A secondary outcome is any adverse event (AE) of Tuina intervention. If samples are enough, a meta-analysis with the software RevMan5.3.5 will be performed. If data permit, a subgroup analysis will be conducted to explain the study findings. RESULTS The study was started on April 30th, 2020. Study results will be submitted for publication in July 2020. CONCLUSIONS This protocol will establish a framework of a high-quality literature synthesis on the impact of Tuina treatment in patients with CNLBP. The proposed review will determine whether Tuina is effective and safe for CNLBP patients. CLINICALTRIAL PROSPERO CRD42020166731

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 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.

Effects of Low Back Pain on Motor Performance in Older People: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Le Ge ◽  
Chuhuai Wang ◽  
Haohan Zhou ◽  
Qiuhua Yu ◽  
Xin Li
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Elderly People ◽  
Motor Performance ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Low Back ◽  
Centre Of Pressure

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 motor 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 motor performance in eldly 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. Two independent reviewers screened the relevant articles, and disagreements were resolved by athird reviewer.Results: Thirteen case-control studies comparing motor performance parameters between LBP and healthy subjects and four randomised controlled studies on physical therapy to improve the motor performance of elderly people with LBP 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) thanthe control group.Conclusion: The results show that motor performance is impaired in elderly people with LBP. We should pay more attention to the balance control of elderly people with LBP.

scholarly journals Comparison of Decompression Alone and Decompression Combined with Fusion for Treating Lumbar Degenerative Spondylolisthesis

2019 ◽  
Author(s):  
wenqiang xin ◽  
Qi-qiang Xin ◽  
xinyu yang
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Degenerative Spondylolisthesis ◽  
Leg Pain ◽  
Cochrane Library ◽  
Low Back ◽  
Vas Score ◽  
Negative Results ◽  
Lumbar Degenerative Spondylolisthesis

Abstract Background To assess the necessity or not of the addition of fusion to decompression for lumber degenerative spondylolisthesis patients.Method Potential publications were selected from PubMed, Web of Science and Cochrane Library. Gray relevant studies were manually searched. We set the searching time spanning from the creating date of electronic engines to August 2019. STATA version 11.0 was exerted to process the pooled data.Results Six RCTs were selected in our analysis. A total of 650 participants were divided into 275 in the decompression group and 375 in the fusion group. Our meta-analysis showed negative results generally. No statistic differences were found in VAS score for low back pain (WMD, -0.045; 95%CI, -1.259 to 1.169; P=0.942) and leg pain (WMD, 0.075; 95% CI, -1.201 to 1.35; P=0.908), ODI score (WMD, 1.489; 95% CI, -7.232 to 10.211; P=0.738), EQ-5D score (WMD, 0.03; 95% CI, -0.05 to 0.12; P=0.43), Odom’s classification (OR, 0.353; 95%CI 0.113, 1.099; P=0.072), postoperative complications (OR, 0.437; 95% CI, 0.065 to 2.949; P=0.395), secondary operation (OR, 2.541; 95% CI 0.897, 7.198; P=0.079) and postoperative degenerative spondylolisthesis (OR=8.59,P=0.27). Subgroup analysis in VAS score on low back pain (OR=0.77, 95% CI, 0.36 to 1.65; P=0.50) was demonstrated as no meaning as well.Conclusion The overall efficacy of the combination of decompression and fusion is not found to be superior to decompression alone. At the same time, more evidence-based performance is needed to supplement this opinion.

scholarly journals Effects of Low Back Pain on Balance Performance in Older People: A Systematic Review and Meta-analysis

2020 ◽  
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 ◽  
Control Group ◽  
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 systematicreview 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. 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 and four randomised controlled studies on physical therapy to improve thebalance performance of elderly people with LBP 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 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 ◽  
Musculoskeletal Disorders ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Low Back ◽  
Working Population ◽  
Pooled Prevalence ◽  
Study Population

Abstract Background: Occupational-related musculoskeletal disorders (MSDs) are a major public health problem and result in the growing demands for utilization of healthcare services, causing temporary and permanent disability and reduced quality of life. In developing countries, particularly Ethiopia, there is no adequate evidence on the overall prevalence of occupational-related MSDs and remains less prioritized and empirically unrepresented. Thus, this study aimed to determine the pooled prevalence of occupational-related musculoskeletal disorders, particularly low and upper back pain among the working population of Ethiopia.Methods: This systematic review and meta-analysis considered studies conducted in Ethiopia, written in English, and published in 2017-2020. The articles were searched using the following electronic databases such as Web of Science, SCOPUS, PubMed, Google Scholar, CINAHL, Cochrane Library, African Index Medicus, African Journals Online database, and Science directly using a combination of Boolean logic operators, Medical Subject Headings, and main keywords. The quality assessment of the articles was performed using the Joanna Briggs Institute Critical Appraisal tools to determine the relevance of the articles to the study.Results: In the current study, the pooled prevalence of occupational-related upper and lower back pain in the previous year was 27.1% [95% of the CI: 18.4, 37.9%] and 54.2% [95% of the CI: 48.2, 60.0%], respectively. However, the pooled prevalence of occupational-related upper back pain in the previous year according to the publication year, the study population and the study area was 43.8% [95% of CI: 39.3, 47.7%], 34.7%[95% of CI: 33.1, 36.2%] and 36.2% [95% of CI: 33.6, 39.0%] respectively while the prevalence of low back pain in the previous year according to the publication year, the study population and the study area was 61.8% [95% of CI: 58.9, 64.6%], 52.8% [95% of CI: 51.3, 54.3%] and 55.2% [95% of CI: 51.4, 59.0%] respectively.Conclusions: This systematic review and meta-analysis found that more than half of the included study participants had experienced low back pain in the previous year, while more than one-fourth of the included participants had experienced upper back pain. Therefore, the application of occupational health and safety practices in the workplace plays an important role in reducing MSDs related to work and other occupational hazards.

scholarly journals Effect of kinesio taping on low back pain during pregnancy: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiali Xue ◽  
Yan Chen ◽  
Xiaorong Mao ◽  
Huan Tu ◽  
Xinwei Yang ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Future Research ◽  
Control Group ◽  
Low Back ◽  
Kinesio Taping ◽  
Significant Difference ◽  
The Difference

Abstract Background Low back pain during pregnancy affects the normal daily activities of pregnant women to a certain extent. Current studies have shown that Kinesio Taping (KT) may be a treatment for low back pain during pregnancy, but there is still a lack of key evidence. The purpose of this study is to evaluate the efficacy and safety of KT in the treatment of low back pain during pregnancy. Methods PubMed, Web of Science, The Cochrane Library, Scopus, Embase, Wanfang Data, CNKI, and VIP databases were searched to collect randomized controlled trials (RCTs) of the efficacy of KT intervention on low back pain in women during pregnancy. The retrieval time limit is from the establishment of the database to April 2021. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. Meta-analysis was performed using RevMan5.3 software. Results A total of 7 RCTs were included, including 444 patients. Meta-analysis results showed that: Compared with the control group, KT intervention could significantly improve low back pain and dysfunction, VAS score (− 1.62, 95%CI − 2.08 to − 1.16, P < 0.00001, I2 = 77%), RMDQ score (− 1.00, 95%CI − 1.54 to − 0.46, P = 0.0003, I2 = 80%); The results of the meta-analysis of the subgroup showed that compared with the control group, the KT intervention was less than or equal to 1 week, and the waist pain and dysfunction were improved, with statistically significant differences. The difference in the improvement of low back pain was statistically significant after KT intervention for more than 1 week, but there was no statistically significant difference in RMDQ score (− 1.25, 95%CI − 2.66 to 0.15, P = 0.08, I2 =77%). Compared with the control group, KT intervention improved low back pain in the second and third trimesters, and the difference was statistically significant. Conclusion KT has a positive effect on the improvement of low back pain during pregnancy, KT intervention can significantly improve pregnant women’s low back pain and dysfunction problems, improve the quality of life. It is suggested that future research should focus on the prevention and treatment of low back pain during pregnancy to provide more research data for improving women’s health.

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 ◽  
Boolean Logic ◽  
Sensitivity Analyses ◽  
Cochrane Library ◽  
Low Back ◽  
Working Population ◽  
Pooled Prevalence

Abstract Background: Back pain such as low and upper back pains are among the most common disabling musculoskeletal conditions that can cause a major public health and socio-economic problems. Back pain is one of the leading causes of disability that reduces worker performance, well-being, and increase 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 language, 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, 95% confidence interval, and the degree of heterogeneity among the included studies. Sensitivity analyses were performed to identify the influence of outliers and to identify the 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 more than half of the included study participants experienced low back pain in the previous year, while more than one-fourth experienced upper back pain. Therefore, implementation of engineering and administrative controls, modifying individual factors, ergonomics, physical examinations and identifying risk factors can reduce back pains.

scholarly journals Drug Therapy for the Treatment of Chronic Nonspecific Low Back Pain: Systematic Review and Meta-analysis

2013 ◽  
Vol 6;16 (6;11) ◽  
pp. E685-E704 ◽  
Author(s):  
Joanne WY Chung
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Drug Therapy ◽  
Pain Relief ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Low Back ◽  
Cox 2 ◽  
The Impact

Background: Low back pain (LBP) is one of the most common health problems in adults. The impact of LBP on the individual can cause loss of health status in the form of symptoms and loss of function related to pain in the back; limitation of daily, leisure, and/or strenuous activities, and disability. LBP also poses an economic burden to society, mainly in terms of one of the most common reasons for seeking medical care (direct treatment costs), and accounts for the large number of work days lost (indirect costs). To reduce the impact of LBP on adults, drug therapy is the most frequently recommended intervention. Over the last decade, a substantial number of randomized clinical trials of drug therapy for LBP have been published. Objective: To determine the effectiveness of drug therapy for the treatment of chronic nonspecific low back pain (CNLBP). Study Design: Systematic review and meta-analysis Methods: A systematic review and meta-analysis of randomized controlled trials was conducted. Five databases (Medline, CINAHL, Science Direct, CAJ Full-text Database, and Cochrane databases) were searched for articles published from 2002 to 2012. The eligibility criteria were randomized trials and double-blind controlled trials of oral or injection drug therapy for CNLBP in subjects who were aged at least 18 years old, published in English or Chinese. Two independent reviewers extracted the data. Results: A total of 25 drug therapy trials were included. cyclo-oxygenase-2 (COX-2) nonsteroidal anti-inflammatory drugs (NSAIDs), tramadol, and opioids were commonly used. Only 5 trials studied the efficacy of adjuvant analgesics of antiepileptics (n = 1) and antidepressants (n = 4) for CNLBP. The standardized mean difference (SMD) for COX-2 NSAIDs in pain relief was -12.03 (95% confidence interval [CI]: -15.00 to -9.06). The SMD for tramadol in pain relief was -1.72 (95% CI: -3.45 to 0.01). As the 95% CI crossed 0, this effect size was not considered statistically significant. The SMD for the overall effects of opioids in pain relief was -5.18 (95% CI: -8.30 to -2.05). The SMD for the partial opioid agonist drug in pain relief was -7.46 (95% CI: -11.87 to -3.04). Limitations: The follow-up periods of these included trials in the meta-analysis ranged from 4 to 24 weeks. The difference of follow-up periods influenced how study outcomes were recorded. These included trials also had significant differences in patient selections. Some trials may actually include CNLBP patients with neuropathic pain, as not having focal neurological findings or signs does not mean that the pain is not neuropathic. Consequently, different pain conditions may influence patients who responded to the same drug and then influence pooled estimates of treatment effect size. Conclusion: This review endorses the use of COX-2 NSAIDs as the first-line drugs for CNLBP. Tramadol shows no statistically significant effect on pain relief, but has small effect sizes in improving functioning. Among included opioid therapy studies, the overall effects of opioids and the partial opioids agonist drug had statistically significant treatment effects in pain relief for CNLBP patients. Key words: NSAIDs, opioids, antidepressants, drug therapy, low back pain, systematic review, meta-analysis, randomized clinical trials

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.

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