Low Back Pain - Related Resources

Cochrane reviews

Physical therapy and exercise

Post-treatment exercise programmes appear to prevent recurrences of low-back pain, but there is conflicting evidence on exercise as part of treatment during an episode of back pain Exercises for Prevention of Recurrences of Low-Back Pain.
Physical conditioning programs seem to reduce sick leaves when compared to usual care in workers with subacute and chronic back pain although the evidence is insufficientPhysical Conditioning Programs for Chronic Back Pain.
Prolotherapy may not be an effective treatment for chronic low-back pain, when used alone. When combined with spinal manipulation, exercise, and other co-interventions, prolotherapy may improve chronic low-back pain and disability Prolotherapy Injections for Chronic Low-Back Pain.
Insoles may not prevent back pain. There is limited evidence that insoles alleviate back pain or adversely shift the pain to the lower extremities Insoles for Prevention of Back Pain.
There is insufficient evidence to support the use of injection therapy in subacute and chronic low-back pain. However, it cannot be ruled out that specific subgroups of patients may respond to a specific type of injection therapy Injection Therapy for Subacute and Chronic Low-Back Pain.

Surgical therapy

The evidence on the surgical interventions of spinal decompression, nerve root decompression, and fusion of adjacent vertebrae in the treatment of degenerative lumbar spondylosis is limited and conflicting Fusion Surgery for Degenerative Lumbar Spondylosis.
There is insufficient evidence to support the use of injection therapy in subacute and chronic low-back pain. However, it cannot be ruled out that specific subgroups of patients may respond to a specific type of injection therapy Injection Therapy for Subacute and Chronic Low-Back Pain.
Radiofrequency denervation appears to offer short-term relief for chronic neck pain of zygapophyseal joint origin and for chronic cervicobrachial pain Radiofrequency Denervation for Neck and Back Pain.
Interventional pain management techniques, percutaneous adhesiolysis and spinal endoscopy, may be effective interventions to treat low back and lower extremity pain caused by epidural adhesions Effectiveness and Complications of Adhesiolysis in the Management of Chronic Spinal Pain.

Pharmaceutical therapy

Harpagophytum procumbens (devil's claw) and Salix alba (white willow bark) appear to reduce pain more than placebo in non-specific low-back pain Herbal Medicine for Low Back Pain.

Patient education

Operant therapy appears to be more effective than waiting list and behavioural therapy more effective than usual care for short-term pain relief in chronic low back pain patientsBehavioural Treatments for Chronic Low Back Pain.
Training workers about proper material handling techniques or providing them with assistive devices appear not to be effective interventions by themselves in preventing back pain. Manual Material Handling Advice and Assistive Devices for Preventing and Treating Back Pain in Workers.
Back-schools appear to be effective for patients with recurrent and chronic low back pain in occupational settings Back Schools for Chronic Non-Specific Low Back Pain.

Others

When used in isolation, most physical tests used to identify lumbar disc herniation may have poor diagnostic performance Physical Examination for Lumbar Radiculopathy in Low-Back Pain.

Other evidence summaries

Programmes aiming at prevention of back injury in the workplace (especially back schools and exercise training programmes) may be effective Back Injury Prevention Interventions in the Workplace.
The squat lifting technique may not bring clear advantage Biomechanical Studies of Lifting Technique.
Spa therapy and balneotherapy may be effective for treating patients with low back pain Spa Therapy and Balneotherapy for Treating Low Back Pain.
Interventional pain management techniques, percutaneous adhesiolysis and spinal endoscopy, may be effective interventions to treat low back and lower extremity pain caused by epidural adhesions Effectiveness and Complications of Adhesiolysis in the Management of Chronic Spinal Pain.
Epidural steroid injections may have limited short-term effectiveness in radicular low back pain Epidural Steroid Injections for Low Back Pain and Sciatica.
Group education is probably not effective for people with low back pain Group Education for Patients with Low Back Pain.

Clinical guidelines

Low back pain -Early management of persistent non-specific low back pain. NICE Clinical Guideline 88, 2009 http://www.nice.org.uk/CG88
New Zealand acute low back pain guide. New Zealand Guidelines Group 2004. Pdf document http://www.nzgg.org.nz/guidelines/0072/acc1038_col.pdf

Literature

Deyo RA, Rainville J, Kent DL. What can the history and physical examination tell us about low back pain? JAMA 1992 Aug 12;268(6):760-5. [PubMed]
van den Hoogen HM, Koes BW, van Eijk JT, Bouter LM. On the accuracy of history, physical examination, and erythrocyte sedimentation rate in diagnosing low back pain in general practice. A criteria-based review of the literature. Spine 1995 Feb 1;20(3):318-27. [PubMed]
Weber H. Lumbar disc herniation. A controlled, prospective study with ten years of observation. Spine 1983 Mar;8(2):131-40. [PubMed]
Andersson GB, Svensson HO, Odén A. The intensity of work recovery in low back pain. Spine 1983 Nov-Dec;8(8):880-4. [PubMed]
Nachemson A. Work for all. For those with low back pain as well. Clin Orthop Relat Res 1983 Oct;(179):77-85. [PubMed]
Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med 1994 Jul 14;331(2):69-73. [PubMed]
Wiesel SW, Tsourmas N, Feffer HL, ym. Wiesel SW, Tsourmas N, Feffer HL, Citrin CM, Patronas N. A study of computer-assisted tomography. I. The incidence of positive CAT scans in an asymptomatic group of patients. Spine 1984 Sep;9(6):549-51. [PubMed]
Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am 1990 Mar;72(3):403-8. [PubMed]
Kostuik JP, Harrington I, Alexander D, ym. Kostuik JP, Harrington I, Alexander D, Rand W, Evans D. Cauda equina syndrome and lumbar disc herniation. J Bone Joint Surg Am 1986 Mar;68(3):386-91. [PubMed]
Vroomen PC, de Krom MC, Wilmink JT, Kester AD, Knottnerus JA. Lack of effectiveness of bed rest for sciatica. N Engl J Med 1999 Feb 11;340(6):418-23. [PubMed]
Laporte JR, Carné X, Vidal X, Moreno V, Juan J. Upper gastrointestinal bleeding in relation to previous use of analgesics and non-steroidal anti-inflammatory drugs. Catalan Countries Study on Upper Gastrointestinal Bleeding. Lancet 1991 Jan 12;337(8733):85-9. [PubMed]
van Tulder M, Malmivaara A, Esmail R, Koes B. Exercise therapy for low back pain: a systematic review within the framework of the cochrane collaboration back review group. Spine 2000 Nov 1;25(21):2784-96. [PubMed]
Brox JI, Hagen KB, Juel NG, Storheim K. [Is exercise therapy and manipulation effective in low back pain?] Tidsskr Nor Laegeforen 1999 May 30;119(14):2042-50. [PubMed]
Koes BW, Assendelft WJ, van der Heijden GJ, Bouter LM. Spinal manipulation for low back pain. An updated systematic review of randomized clinical trials. Spine 1996 Dec 15;21(24):2860-71; discussion 2872-3. [PubMed]
Koes BW, van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ 2007 Jun 23;334(7607):1313-7. [PubMed]
Devillé WL, van der Windt DA, Dzaferagic A, Bezemer PD, Bouter LM. The test of Lasègue: systematic review of the accuracy in diagnosing herniated discs. Spine 2000 May 1;25(9):1140-7. [PubMed]
Malmivaara A, Slätis P, Heli�vaara M, Sainio P, Kinnunen H, Kankare J, Dalin-Hirvonen N, Seitsalo S, Herno A, Kortekangas P, Niinimäki T, R�nty H, Tallroth K, Turunen V, Knekt P, Härkänen T, Hurri H, Finnish Lumbar Spinal Research Group. Surgical or nonoperative treatment for lumbar spinal stenosis? A randomized controlled trial. Spine 2007 Jan 1;32(1):1-8. [PubMed]
Chou R, Fu R, Carrino JA, Deyo RA. Imaging strategies for low-back pain: systematic review and meta-analysis. Lancet 2009 Feb 7;373(9662):463-72. [PubMed]

Primary/Secondary Keywords

Related resources

section name header

References

Low Back Pain - Related Resources

Cochrane reviews

Physical therapy and exercise

Surgical therapy

Pharmaceutical therapy

Patient education

Others

Other evidence summaries

Clinical guidelines

Literature