Photobiomodulation therapy is not better than placebo in patients with chronic nonspecific low back pain: a randomised placebo-controlled trial

Photobiomodulation therapy (PBMT) has been used in several musculoskeletal disorders to reduce pain, inflammation, and promoting tissue regeneration. The current evidence about the effects of PBMT on low back pain (LBP) is still conflicting. We aimed to evaluate the effects of PBMT against placebo on pain intensity and disability in patients with chronic nonspecific LBP. This was a prospectively registered, randomised placebo-controlled trial, with blinded patients, therapists, and assessors. The study was conducted on an outpatient physical therapy clinic in Brazil, between April 2017 and May 2019. A total of 148 patients with chronic nonspecific LBP were randomised to either active PBMT (n = 74) or placebo (n = 74). Patients from both groups received 12 treatment sessions, 3 times a week, for 4 weeks. Patients from both groups also received an educational booklet based on “The Back Book.” Clinical outcomes were measured at baseline and at follow-up appointments at 4 weeks, 3, 6, and 12 months after randomisation. The primary outcomes were pain intensity and disability measured at 4 weeks. We estimated the treatment effects using linear mixed models following the principles of intention-to-treat. There was no clinical important between-group differences in terms of pain intensity (mean difference = 0.01 point; 95% confidence interval = −0.94 to 0.96) and disability (mean difference = −0.63 points; 95% confidence interval = −2.23 to 0.97) at 4 we...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research

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We report the four-year outcomes of this trial.Materials and MethodsReActiv8-A is a prospective, single-arm trial performed at nine sites in the United  Kingdom, Belgium, and Australia. Eligible patients had disabling CLBP (low back pain Numeric Rating Scale [NRS] ≥6; Oswestry Disability Index [ODI] ≥25), no indications for spine surgery or spinal cord stimulation, and failed conventional management including at least physical therapy and med ications for low back pain. Fourteen days postimplantation, stimulation parameters were programmed to elicit strong, smooth contractions of the multifidus, and participan...
Source: Neuromodulation: Technology at the Neural Interface - Category: Biotechnology Authors: Tags: Clinical Research Source Type: research
Study Design. A randomized clinical trial. Objective. The aim of this article is to determine the effectiveness of neural therapy (NT) in patients with chronic low back pain (LBP) who are resistant to medical and physical therapies. Summary of Background Data. Patients with LBP generally respond well to the treatment, whereas some cases do not improve via medical and physical therapies. Although trigger point injections (TPIs) may be an effective short-term treatment in selected patients with LBP, they are not recommended in patients with chronic LBP due to a long-lasting benefit not being demonstrated. ...
Source: Spine - Category: Orthopaedics Tags: RANDOMIZED TRIAL Source Type: research
Phys Ther. 2021 May 17:pzab132. doi: 10.1093/ptj/pzab132. Online ahead of print.ABSTRACTOBJECTIVE: Chronic low back pain (cLBP) is the leading cause of disability. Interdisciplinary pain management is recommended for patients with severe cLBP. Such programs are expensive, not easily accessible, and have limited effect and therefore new cost-effective strategies are warranted. Cognitive Functional Therapy (CFT) has shown promising results, but has not been compared with an interdisciplinary pain management approach. The primary aim of this randomized controlled trial (RCT) is to investigate if a pathway starting with CFT in...
Source: Physical Therapy - Category: Physiotherapy Authors: Source Type: research
CONCLUSION: Educational intervention did not confer clinically-relevant improvements in patient-specific disability, and did not influence pain in patients with nonspecific chronic LBP and low risk of poor prognosis. Additionally, there was no difference between intervention with or without emphasis on the therapeutic alliance. J Orthop Sports Phys Ther, Epub 7 May 2021. doi:10.2519/jospt.2021.9636.PMID:33962515 | DOI:10.2519/jospt.2021.9636
Source: Physical Therapy - Category: Physiotherapy Authors: Source Type: research
EClinicalMedicine. 2021 Mar 30;34:100795. doi: 10.1016/j.eclinm.2021.100795. eCollection 2021 Apr.ABSTRACTBACKGROUND: Many patients with acute low back pain (LBP) first seek care from primary care physicians. Evidence is lacking for interventions to prevent transition to chronic LBP in this setting. We aimed to test if implementation of a risk-stratified approach to care would result in lower rates of chronic LBP and improved self-reported disability.METHODS: We conducted a pragmatic, cluster randomized trial using 77 primary care clinics in four health care systems across the United States. Practices were randomly assigne...
Source: Pain Physician - Category: Anesthesiology Authors: Source Type: research
Did you know that antidepressant medications are often prescribed for people without depression? It’s true. Antidepressants are frequently prescribed for chronic pain, especially pain related to nerve disease (called neuropathic pain), chronic low back or neck pain, and certain types of arthritis. In fact, some guidelines for the treatment of chronic low back pain and osteoarthritis (the most common type of arthritis) include antidepressants. One antidepressant in particular, duloxetine (Cymbalta), is FDA-approved for these conditions. Just how antidepressants reduce pain is not well understood. One possibility is th...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Back Pain Bones and joints Health Osteoarthritis Pain Management Source Type: blogs
J Osteopath Med. 2021 Apr 14. doi: 10.1515/jom-2020-0238. Online ahead of print.ABSTRACTCONTEXT: Chronic low back pain (cLBP) is the second leading cause of disability in the United States, with significant physical and financial implications. Development of a multifaceted treatment plan that is cost effective and optimizes patients' ability to function on a daily basis is critical. To date, there have been no published prospective studies comparing the cost of osteopathic manipulative treatment to that of standard care for patients with cLBP.OBJECTIVES: To contrast the cost for standard of care treatment (SCT) for cLBP wi...
Source: Pain Physician - Category: Anesthesiology Authors: Source Type: research
CONCLUSIONS: The findings from the present study reveal that flexion exercises are not inferior to and offer a similar response to stabilization exercises for the control of pain and improvements of disability in patients with chronic low back pain and degenerative spondylolisthesis.IMPACT STATEMENT: Exercise is the mainstay of treatment in patients with chronic low back pain and degenerative spondylolisthesis, however, there is still no consensus surrounding the superiority of any specific exercise program. This study finds that flexion exercises are not inferior to and offer a similar response to stabilization exercises....
Source: Physical Therapy - Category: Physiotherapy Authors: Source Type: research
Disabil Rehabil. 2021 Mar 16:1-7. doi: 10.1080/09638288.2021.1900415. Online ahead of print.ABSTRACTPURPOSE: To translate and validate the Greek version of the Somatic Symptom Scale-8 (SSS-8) in patients with chronic low back pain (CLBP).MATERIALS AND METHODS: The Greek SSS-8, created through forth and back translation and cultural adaption processes, was handed over to 145 patients recruited using simple random sampling. Test-retest, composite, and internal consistency reliability were assessed. Construct validity was examined by assessing correlations with Patient Health Questionnaire-15 (PHQ-15), Patient Health Question...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Source Type: research
This study explored physiotherapists experiences over time of the PACT training programme and intervention delivery.
Source: Physiotherapy - Category: Physiotherapy Authors: Source Type: research
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