Effectiveness of treatments for acute and sub-acute mechanical non-specific low back pain: protocol for a systematic review and network meta-analysis

The objective of this study will be to identify the most effective interventions to relieve pain and reduce disability in acute and sub-acute non-specific LBP.Methods/designWe will search electronic databases (MEDLINE, Embase, CENTRAL) from inception onwards. The eligible population will be individuals with non-specific LBP older than 18  years, both males and females, who experience pain less than 6 weeks (acute) or between 6 and 12 weeks (subacute). Eligible interventions and comparators will include all conservative rehabilitation or pharmacological treatments provided by any health professional; the only eligible study des ign will be a randomized controlled trial. The primary outcomes will be pain intensity and back-specific functional status. Secondary outcomes will be any adverse events. Studies published in languages other than English will also potentially be included. Two reviewers will independently screen the titles and abstracts retrieved from a literature search, as well as potentially relevant full-text articles. General characteristics, potential effect modifiers, and outcome data will be extracted from the included studies, and the risk of bias will be appraised. Conflicts at all levels of screening and abstraction will be resolved through team discussions. After describing the results of the review, if appropriate, a random effects meta-analysis and network meta-analysis will be conducted in a frequentist setting, assuming equal heteroge...
Source: Systematic Reviews - Category: International Medicine & Public Health Source Type: research

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CONCLUSION: Sexual disability in patients with subacute or chronic LBP acquires an important and individual meaning that can be investigated within the therapeutic context, especially by physical therapists. Implications for Rehabilitation Sexual disability related to low back pain is considered an important and meaningful topic from the patient's perspective. This reflects the importance of the emotional relationship with the partner. Within the therapeutic context, it is important to provide information to help manage pain during sexual activity. The physical therapist is seen to be a qualified figure to address this iss...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
Alert: rant ahead. Early in my career working in persistent pain management, it was thought that “chronic pain is chronic pain is chronic pain” and pretty much anything that helped one person would help the next. Over time we’ve learned a lot more about persistent pain: the mechanisms differ a lot between neuropathic mechanisms and nociplastic mechanisms. Even within these groups, the mechanisms are very different. We’ve also learned a lot more about the psychosocial variables that are associated with prolonged disability and distress when pain persists. Some of the earliest work by Turk and coll...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Groupwork Interdisciplinary teams Pain conditions Research Science in practice Source Type: blogs
Authors: Migliorini F, Maffulli N, Eschweiler J, Betsch M, Catalano G, Driessen A, Tingart M, Baroncini A Abstract INTRODUCTION: Treating chronic low back pain (LBP) can be challenging, and the most effective pharmacological therapy is controversial. The present systematic review investigated the efficacy of various pharmacological compounds to achieve pain relief and improve disability in chronic LBP patients. The present study focused on acetaminophen, amoxicillin, flupirtine, baclofen, tryciclic antidepressants (TCAs), duloxetine, topiramate, gabapentinoids, non-steroid anti-inflammatory drugs (NSAIDs) and opioi...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research
Chronic/persistent pain management is not sexy. No-one gets a magic cure. Lives are not saved – at least not in a way that mortality statistics show. Chronic pain management is under-funded. And now: buried in a list of other proposed service cuts in the local health board’s plan to save millions of dollars, is a proposal to “save” $650,000 from the pain clinic. You’ll note also reductions in community services, GP support for vulnerable, and healthy lifestyles programmes. https://www.stuff.co.nz/national/health/122558278/hundreds-of-staff-nurses-and-services-may-be-axed-at-canterbury-d...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Interdisciplinary teams News Pain conditions Research Science in practice Uncategorized Source Type: blogs
A couple of weeks back I posted about my concerns that exercise is often over-hyped, has limited effects on pain and disability, and therefore people going through a rehabilitation programme will likely dump doing the exercises as soon as the programme ends. Well, that was an interesting conversation starter! TBH I expected the response. On the one hand we have avid strength and conditioning people (including a whole bunch of physiotherapists) saying it’s crucial to get strong and fit because it’s good for health and longevity, while on the other hand we have a large group of “others” who think life...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Clinical reasoning Pain conditions Professional topics Research Science in practice goal setting Source Type: blogs
AbstractPurpose of ReviewChronic low back pain (CLBP) is a major cause of disability in the USA, and it affects approximately 1 in 4 Americans. CLBP patients are commonly referred to or seek out neurosurgical evaluations and opinions for treatment and management.Recent FindingsLiterature shows that only a minority of patients with CLBP may benefit from a surgical procedure. These patients that present to clinic often have been ailing for a considerable amount of time and are eager for effective treatment to alleviate pain. However, determining if a patient with CLBP is a surgical candidate is predicated upon having no succ...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
If you haven’t heard about the health benefits of exercise in the last 10 years or longer, then you’ve probably been a hermit! Exercise can do all these wonderful things – help you lose weight, reduce heart disease, moderate insulin and blood glucose levels, improve your mental health, and yes! reduce pain and disability when you’re sore. (check this list out) The claims sound suspiciously similar to the claims made by old snake oil merchants – or the amazing White Cross Electric Vibrator! Well perhaps there’s a little more research supporting claims for exercise… but a...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Coping strategies Motivation Professional topics Resilience/Health Science in practice exercise movement persistent pain Source Type: blogs
CONCLUSIONS: The evidence from this systematic review is uncertain regarding the effect of therapeutic ultrasound on pain in individuals with chronic non-specific LBP. Whilst there is some evidence that therapeutic ultrasound may have a small effect on improving low back function in the short term compared to placebo, the certainty of evidence is very low. The true effect is likely to be substantially different. There are few high-quality randomised trials, and the available trials were very small. The current evidence does not support the use of therapeutic ultrasound in the management of chronic LBP. PMID: 32623724 ...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Abstract OBJECTIVE: To evaluate the efficacy of a newly developed evidence-based low back pain (LBP) management smartphone application. DESIGN: A double-blinded randomized controlled trial where participants randomly assigned to either an experimental group (EG) or a control group (CG). SETTING: Governmental and private institutions. PARTICIPANTS: About 40 office workers, aged 30 to 55 years, had pain due to non-specific LBP > 3 on Visual Analogue Scale, and with pain chronicity > 3 months. INTERVENTIONS: The EG received full version of the applic...
Source: Clinical Rehabilitation - Category: Rehabilitation Authors: Tags: Clin Rehabil Source Type: research
Conclusion: Insomnia was associated with disability in men, whereas aging and pain severity were associated with disability in women. Catastrophic thinking was not associated with disability in both sexes. PMID: 32454923 [PubMed - in process]
Source: Pain Research and Management - Category: Anesthesiology Authors: Tags: Pain Res Manag Source Type: research
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