Articles: low-back-pain.
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Cochrane Db Syst Rev · Jan 2007
Review Meta AnalysisLow level laser therapy for nonspecific low-back pain.
Low-back pain (LBP) and related disabilities are major public health problems and a major cause of medical expenses, absenteeism and disablement. Low level laser therapy (LLLT) can be used as a therapeutic intervention for musculoskeletal disorders such as back pain. ⋯ No side effects were reported. However, we conclude that there are insufficient data to draw firm conclusions. There is a need for further methodologically rigorous RCTs to evaluate the effects of LLLT compared to other treatments, different lengths of treatment, different wavelengths and different dosages. Comparison of different LLLT treatments will be more reasonable if dose calculation methods are harmonized.
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The use of opioids in the long-term management of chronic low-back pain (LBP) appears to be increasing. Despite this trend, the benefits and risks of these medications remain unclear. ⋯ Despite concerns surrounding the use of opioids for long-term management of chronic LBP, there remain few high-quality trials assessing their efficacy. The trials in this review, although achieving high internal validity scores, were characterized by a lack of generalizability, inadequate description of study populations, poor intention-to treat analysis, and limited interpretation of functional improvement. Based on our results, the benefits of opioids in clinical practice for the long-term management of chronic LBP remains questionable. Therefore, further high-quality studies that more closely simulate clinical practice are needed to assess the usefulness, and potential risks, of opioids for individuals with chronic LBP.
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Review Meta Analysis
Spa therapy and balneotherapy for treating low back pain: meta-analysis of randomized trials.
Low back pain is a major public health concern and complementary treatments are frequently used for this condition. The objective of this systematic review and meta-analysis was to assess the evidence for or against the effectiveness of spa therapy and balneotherapy for treating low back pain. ⋯ Even though the data are scarce, there is encouraging evidence suggesting that spa therapy and balneotherapy may be effective for treating patients with low back pain. These data are not compelling but warrant rigorous large-scale trials.
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Review Meta Analysis
The McKenzie method for low back pain: a systematic review of the literature with a meta-analysis approach.
Meta-analysis of randomized controlled trials to evaluate the effectiveness of the McKenzie method for low back pain (LBP). ⋯ There is some evidence that the McKenzie method is more effective than passive therapy for acute LBP; however, the magnitude of the difference suggests the absence of clinically worthwhile effects. There is limited evidence for the use of McKenzie method in chronic LBP. The effectiveness of classification-based McKenzie is yet to be established.
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Heat and cold are commonly utilised in the treatment of low-back pain by both health care professionals and people with low-back pain. ⋯ The evidence base to support the common practice of superficial heat and cold for low back pain is limited and there is a need for future higher-quality randomised controlled trials. There is moderate evidence in a small number of trials that heat wrap therapy provides a small short-term reduction in pain and disability in a population with a mix of acute and sub-acute low-back pain, and that the addition of exercise further reduces pain and improves function. The evidence for the application of cold treatment to low-back pain is even more limited, with only three poor quality studies located. No conclusions can be drawn about the use of cold for low-back pain. There is conflicting evidence to determine the differences between heat and cold for low-back pain.