Best Treatments for Chronic Low Back Pain
Low back pain is the leading cause of disability
While Chronic Low Back Pain (CLBP) makes up approximately 20% of all low back pain cases, it generates approximately 80% of the direct costs.
Owen et al. (2019), evaluated the efficacy of interventions best capable of treating nonspecific CLBP.
A Systematic Review and Meta-Analysis was performed, including effects on:
Hands-Off (Education, and general practitioner management).
9543 records we found.
89 studies, including 5578 patients were eligible for qualitative synthesis.
Studies included for Network Meta-analyis:
63 (physical function)
16 (mental health)
4 (trunk muscle strength)
Most Beneficial Exercise Training Modalities:
Pilates for pain.
Resistance and stabilization/motor control for physical function.
Resistance and Aerobic for mental health. .
Least Beneficial Modalities in Order:
True control was most likely to be the worst treatment for all outcomes.
Hands-off treatments for pain and physical function.
Manual Therapy for mental health.
Stretching and McKenzie exercise effect sizes did not differ to true control for pain or function. .
Low quality evidence Suggests:
Pilates, Stabilization/motor control, Resistance training and Aerobic exercise training are the most effective treatments, for adults with Non-specific CLBP. .
Exercise training may also be more effective than therapist hands-on treatment. .
Low Quality Evidence according to Grading of Recommendations Assessment, Development and Evaluation criteria. .
Thoughts? Questions? Comments?
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Owen PJ, Miller CT, Mundell NL, et al. Br J Sports Med. doi:10.1136/ bjsports-2019-100886