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The results were comparable to recent systematic reviews, which have found evidence to support the use of exercise therapy, in mixed populations of workers. There is a need for further research to highlight the most effective form of exercise, optimal dosage and delivery method.

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Preliminary evidence exists, demonstrating that vitamins and amino acids may facilitate multilevel changes in musculotendinous healing; however, recommendations on clinical utility should be made with caution. All animal studies and one human study showed high risk of bias with moderate interobserver agreement (k = 0.46). Currently, there is limited evidence to support the use of vitamins and amino acids for musculotendinous injury. Both high-quality animal experimentation of the proposed mechanisms confirming the physiological influence of supplementation and human studies evaluating effects on tissue morphology and biochemistry are required before practical application.

Educational materials alone do not appear to reduce sickness absence for LBP in the 'non-heavy' manual working population. However, they can facilitate behavioural change and modify health beliefs and attitudes. Educational materials may be a useful medium to engage workers, provide information regarding practical modifications to their work environment and activities and potentially reduce psychological distress regarding ill-health at work.

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