Back schools for the treatment of chronic low back pain: possibility of benefit but no convincing evidence after 47 years of research—systematic review and meta-analysis

Abstract: Back schools are interventions that comprise exercise and education components. We aimed to systematically review the randomized controlled trial evidence on back schools for the treatment of chronic low back pain. By searching MEDLINE, Embase, and Cochrane Central as well as bibliographies, we identified 31 studies for inclusion in our systematic review and 5 of these for inclusion in meta-analyses. Meta-analyses for pain scores and functional outcomes revealed statistical superiority of back schools vs no intervention for some comparisons but not others. No meta-analysis was feasible for the comparison of back schools vs other active treatments. Adverse events were poorly reported so that no reliable conclusions regarding the safety of back schools can be drawn, although some limited reassurance in this regard may be derived from the fact that few adverse events and no serious adverse events were reported in the back school groups in the studies that did report on safety. Overall, the evidence base for the use of back schools to treat chronic low back pain is weak; in nearly a half-century since back schools were first trialled, no unequivocal evidence of benefit has emerged.
Source: Pain - Category: Anesthesiology Tags: Comprehensive Review Source Type: research

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(Boston Medical Center) Yoga and physical therapy (PT) are effective approaches to treating co-occurring sleep disturbance and back pain while reducing the need for medication, according to a new study from Boston Medical Center. Published in the Journal of General Internal Medicine, the research showed significant improvements in sleep quality lasting 52 weeks after 12 weeks of yoga classes or 1-on-1 PT, which suggests a long-term benefit of these non-pharmacologic approaches.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
Epidural injections are routinely used for management of radicular pain and are prevalent nonsurgical interventions for chronic low back pain. Pneumocephalus is a rare complication that may occur as a result of inadvertent dural puncture with an epidural needle. Pneumocephalus-induced cranial nerve deficit is also rare, with only a few reported cases.
Source: The Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Clinical Communications: Adult Source Type: research
To investigate the effectiveness of spinal manipulation combined with myofascial release compared with spinal manipulation alone, in individuals with chronic non-specific low back pain (CNLBP).
Source: Physiotherapy - Category: Physiotherapy Authors: Source Type: research
Conclusions: Similar to previous studies, our results suggest that patients suffering from CLBP differ with regard to the magnitude of mental burden and the presence of physical impairment. These differences ascertain the need for precise targeting of treatment for CLBP. Inpatient pain centers therefore should offer different multimodal therapy pathways and integrate a meaningful triage, taking into account the multifaceted nature of CLBP based on sophisticated knowledge about forms, differences, and relationships among the biopsychosocial components of CLBP. PMID: 31728134 [PubMed - in process]
Source: GMS German Medical Science - Category: General Medicine Tags: Ger Med Sci Source Type: research
Condition:   Low Back Pain Interventions:   Behavioral: Qigong Exercise;   Behavioral: P.Volve Exercises Sponsor:   University of Minnesota Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
In the last decade, prescription of anticonvulsants for treatment of low back pain (LBP) increased 4-fold. Among them, topiramate has frequent side effects and a mechanism of action that is not fully understood. The authors describe a 65-year-old woman with dependence on topiramate prescribed for chronic LBP and discuss how she was successfully weaned off topiramate using duloxetine. A significant agonistic effect by topiramate on α-2 adrenergic receptors in the brain likely accounts for the symptoms of withdrawal that were seen. We attribute the resolution of her topiramate withdrawal symptoms to reduced norepinephr...
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports Source Type: research
Introduction Exercise therapy (ET) is advocated as a treatment for chronic nonspecific low back pain (CNSLBP). However, therapy effect sizes remain low. In other chronic disorders, training at higher intensity has resulted in greater improvements on both general health related and disease specific outcomes compared to lower-intensity ET. Possibly, high-intensity training also improves effect sizes in CNSLBP. Objective To compare the effects of a high-intensity ET program with a similar moderate-intensity ET program on disability, pain, function, exercise capacity, and abdominal/back muscle strength in persons with CNS...
Source: Medicine and Science in Sports and Exercise - Category: Sports Medicine Tags: CLINICAL SCIENCES Source Type: research
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Source: Conversations with Dr Greene - Category: Child Development Authors: Tags: Dr. Greene's Blog Uncategorized Bath Time Natural Source Type: blogs
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Source: European Journal of Orthopaedic Surgery and Traumatology - Category: Orthopaedics Source Type: research
ConclusionsThe findings support the reliability and validity of the T-PROMIS-29 scale scores. The measure can be used to assess key quality of life domains in individuals from Thailand with chronic low back pain.
Source: Quality of Life Research - Category: Health Management Source Type: research
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