A Critical Review of Low Back Pain Guidelines

Chetty, Laran

doi:10.1177/2165079917702384

Cited by 14 publications

(9 citation statements)

References 28 publications

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“…Current guidelines for chronic LBP recommend exercise in combination with massage as a treatment option [18,19]. The MDT, which prescribes repeated exercise in a specific direction along with an educational approach, is one of the strategies recommended by LBP guidelines [20].…”

Section: Discussionmentioning

confidence: 99%

Combination of Rehabilitative Therapy with Ultramicronized Palmitoylethanolamide for Chronic Low Back Pain: An Observational Study

et al. 2019

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Introduction: Chronic low back pain (LBP) caused by intervertebral disc herniation was reported in the 2010 Global Burden of Disease study to be the main reason for years lived with disability. It causes significant personal, social, and economic burdens. Many of those who suffer from LBP find conventional medical treatments to be unsatisfactory for treating their pain, so they are increasingly resorting to complementary and alternative medicine (CAM) therapies. Given that the population is aging, there is an urgent need to characterize the combinations of complementary therapies that yield the best outcomes and treatments, even for prolonged periods. This observational study aimed to evaluate the effect of ultramicronized palmitoylethanolamide (umPEA) ? CAM (daily functional rehabilitation ? decontracting massage) therapies on chronic pain in patients suffering from multiple herniated discs in the lumbar spine. Methods: Eligible patients received 600 mg of umPEA twice a day in combination with a daily functional rehabilitation session according to the McKenzie Method of Mechanical Diagnosis and Therapy plus a decontracting massage for 20 consecutive days, followed by 600 mg of umPEA once a day for 40 days in addition to standard therapy. Results: The results showed that the average pain intensity score, evaluated via the Numeric Rating Scale, progressively decreased during the study period, reaching a value that was not clinically relevant at the end of the observation period. Pain relief was paralleled by improvements in the physical and mental components of quality of life as evaluated with the SF-36 questionnaire as well as in disability for low back pain as evaluated with the Oswestry Disability Questionnaire. Collectively, the results demonstrate that umPEA in combination with CAM therapies could be an important strategy for combating LBP. Conclusions: The multiple action of PEA in combination with CAM therapies may represent the multitarget approach needed to tackle the as-yet unsolved problem of chronic pain resistant to conventional therapies.

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Section: Discussionmentioning

confidence: 99%

Combination of Rehabilitative Therapy with Ultramicronized Palmitoylethanolamide for Chronic Low Back Pain: An Observational Study

et al. 2019

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“…A critical review of LBP guidelines (2017) [81] used the Appraisal of Guidelines Research and Evaluation (AGREE) instrument to assess their quality and recommends four (out of 17 available) guidelines for LBP management [40,82,83,84]. Two of these guidelines (NICE guidelines and Dutch physiotherapy guidelines) focused on CLBP as a specific group apart from (sub)acute LBP [40,82] and will be discussed here.…”

Section: State Of the Artmentioning

confidence: 99%

Best Evidence Rehabilitation for Chronic Pain Part 3: Low Back Pain

Malfliet

Ickmans

Huysmans

et al. 2019

JCM

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Chronic Low Back Pain (CLBP) is a major and highly prevalent health problem. Given the high number of papers available, clinicians might be overwhelmed by the evidence on CLBP management. Taking into account the scale and costs of CLBP, it is imperative that healthcare professionals have access to up-to-date, evidence-based information to assist them in treatment decision-making. Therefore, this paper provides a state-of-the-art overview of the best evidence non-invasive rehabilitation for CLBP. Taking together up-to-date evidence from systematic reviews, meta-analysis and available treatment guidelines, most physically inactive therapies should not be considered for CLBP management, except for pain neuroscience education and spinal manipulative therapy if combined with exercise therapy, with or without psychological therapy. Regarding active therapy, back schools, sensory discrimination training, proprioceptive exercises, and sling exercises should not be considered due to low-quality and/or conflicting evidence. Exercise interventions on the other hand are recommended, but while all exercise modalities appear effective compared to minimal/passive/conservative/no intervention, there is no evidence that some specific types of exercises are superior to others. Therefore, we recommend choosing exercises in line with the patient’s preferences and abilities. When exercise interventions are combined with a psychological component, effects are better and maintain longer over time.

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“…Chronic low back pain (CLBP) is a major common public health condition; [1–3] with a 12- month prevalence of 66% in women and 58% in men, [4] and a lifetime prevalence of 84%. [5,6] This condition is also a leading cause of disability worldwide.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic effectiveness of neuromuscular electrical stimulation for treating patients with chronic low back pain

Guo¹,

Wang²,

Tong

2018

Medicine

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This retrospective study investigated the effectiveness and safety of neuromuscular electrical stimulation (NMES) for patients with chronic low back pain (CLBP).A total of 72 patients with CLBP were included in this retrospective study. All patients received usual care, and were assigned to a NMES group (n = 36) and a control group (n = 36). In addition, patients in the NMES group also received NMES for a total of 4 weeks. The primary outcome was pain intensity, measured by numerical rating scale (NRS). The secondary outcome was disability, assessed by the Roland–Morris Disability Questionnaire (RMDQ), and the Quebec Back Pain Disability Scale (QBPDS). The outcomes were evaluated before and after 4-week treatment.After 4-week treatment, the patients in the NMES group did not show better effectiveness in pain intensity relief, as measured by NRS (P = .11); and disability improvement, as evaluated by the RMDQ (P = .14), and QBPDS (P = .33), when compared with the patients in the control group. Additionally, no adverse events related to the NNES were recorded.The results of this study did not show promising effectiveness of NMES for patients with CLBP after 4-week treatment.

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A Critical Review of Low Back Pain Guidelines

Cited by 14 publications

References 28 publications

Combination of Rehabilitative Therapy with Ultramicronized Palmitoylethanolamide for Chronic Low Back Pain: An Observational Study

Combination of Rehabilitative Therapy with Ultramicronized Palmitoylethanolamide for Chronic Low Back Pain: An Observational Study

Best Evidence Rehabilitation for Chronic Pain Part 3: Low Back Pain

Therapeutic effectiveness of neuromuscular electrical stimulation for treating patients with chronic low back pain

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