Articles: low-back-pain.
-
Swiss medical weekly · Jan 2010
Randomized Controlled Trial Comparative StudyFunctional multidisciplinary rehabilitation versus outpatient physiotherapy for non specific low back pain: randomized controlled trial.
In recent decades the treatment of non-specific low back pain has turned to active modalities, some of which were based on cognitive-behavioural principles. Non-randomised studies clearly favour functional multidisciplinary rehabilitation over outpatient physiotherapy. However, systematic reviews and meta-analysis provide contradictory evidence regarding the effects on return to work and functional status. The aim of the present randomised study was to compare long-term functional and work status after 3-week functional multidisciplinary rehabilitation or 18 supervised outpatient physiotherapy sessions. ⋯ Functional multidisciplinary rehabilitation was better than outpatient physiotherapy in improving functional and work status. From an economic point of view, these results should be backed up by a cost-effectiveness study.
-
Low back pain (LBP) is a prevalent and costly musculoskeletal disorder that often occurs in the working-age population. Although numerous physical activities have been implicated in its complex etiology, determining causation remains challenging and requires a methodologically rigorous approach. ⋯ There was strong evidence from six high-quality studies that there was no association between awkward postures and LBP. Similarly, there was strong evidence from three high-quality studies that there was no temporal relationship. Moreover, subgroup analyses identified only a handful of studies that demonstrated only weak associations and no evidence for other aspects of causality in certain specific subcategories. It is therefore unlikely that awkward occupational postures are independently causative of LBP in the populations of workers studied.
-
Bmc Musculoskel Dis · Jan 2010
Randomized Controlled Trial Multicenter StudyAcupuncture for chronic low back pain: protocol for a multicenter, randomized, sham-controlled trial.
Use of acupuncture has widely increased in patients with chronic low back pain. However, the evidence supporting its efficacy remains unclear. In this article, we report the design and the protocol of a multi-center randomized sham-controlled trial to treat chronic low back pain. Our goal is to verify the effect of acupuncture on chronic low back pain. ⋯ The result of this trial (which will be available in 2010) will demonstrate the efficacy of using acupuncture to treat chronic low back pain.
-
Low back pain (LBP) is a common musculoskeletal disorder that often occurs in the working-age population. Although numerous physical activities have been implicated in its etiology, determining causation remains challenging and requires a methodologically rigorous approach. ⋯ A summary of existing studies was not able to find high-quality studies that satisfied more than three of the Bradford-Hill criteria for causation for either occupational bending or twisting and LBP. Conflicting evidence in multiple criteria was identified. This suggests that specific subcategories could contribute to LBP. However, the evidence suggests that occupational bending or twisting in general is unlikely to be independently causative of LBP.
-
Bmc Musculoskel Dis · Jan 2010
Randomized Controlled TrialPACE--the first placebo controlled trial of paracetamol for acute low back pain: design of a randomised controlled trial.
Clinical practice guidelines recommend that the initial treatment of acute low back pain (LBP) should consist of advice to stay active and regular simple analgesics such as paracetamol 4 g daily. Despite this recommendation in all international LBP guidelines there are no placebo controlled trials assessing the efficacy of paracetamol for LBP at any dose or dose regimen. This study aims to determine whether 4 g of paracetamol daily (in divided doses) results in a more rapid recovery from acute LBP than placebo. A secondary aim is to determine if ingesting paracetamol in a time-contingent manner is more effective than paracetamol taken when required (PRN) for recovery from acute LBP. ⋯ The successful completion of the trial will provide the first high quality evidence on the effectiveness of the use of paracetamol, a guideline endorsed treatment for acute LBP.