Skip to main content
Erschienen in: European Spine Journal 11/2007

01.11.2007 | Review article

Effect sizes of non-surgical treatments of non-specific low-back pain

verfasst von: A. Keller, J. Hayden, C. Bombardier, M. van Tulder

Erschienen in: European Spine Journal | Ausgabe 11/2007

Einloggen, um Zugang zu erhalten

Abstract

Numerous randomized trials have been published investigating the effectiveness of treatments for non-specific low-back pain (LBP) either by trials comparing interventions with a no-treatment group or comparing different interventions. In trials comparing two interventions, often no differences are found and it raises questions about the basic benefit of each treatment. To estimate the effect sizes of treatments for non-specific LBP compared to no-treatment comparison groups, we searched for randomized controlled trials from systematic reviews of treatment of non-specific LBP in the latest issue of the Cochrane Library, issue 2, 2005 and available databases until December 2005. Extracted data were effect sizes estimated as Standardized Mean Differences (SMD) and Relative Risk (RR) or data enabling calculation of effect sizes. For acute LBP, the effect size of non-steroidal anti-inflammatory drugs (NSAIDs) and manipulation were only modest (ES: 0.51 and 0.40, respectively) and there was no effect of exercise (ES: 0.07). For chronic LBP, acupuncture, behavioral therapy, exercise therapy, and NSAIDs had the largest effect sizes (SMD: 0.61, 0.57, and 0.52, and RR: 0.61, respectively), all with only a modest effect. Transcutaneous electric nerve stimulation and manipulation had small effect sizes (SMD: 0.22 and 0.35, respectively). As a conclusion, the effect of treatments for LBP is only small to moderate. Therefore, there is a dire need for developing more effective interventions.
Literatur
1.
Zurück zum Zitat Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, Mannion AF, Reis S, Staal JB, Ursin H, Zanoli G (2006) Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 15(Suppl 2):S192–S300PubMedCrossRef Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, Mannion AF, Reis S, Staal JB, Ursin H, Zanoli G (2006) Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 15(Suppl 2):S192–S300PubMedCrossRef
2.
Zurück zum Zitat Arbus L, Fajadet B, Aubert D, Morre M, Goldfinger E (1990) Activity of tetrazepam in low back pain. Clin Trials J 27:58–67 Arbus L, Fajadet B, Aubert D, Morre M, Goldfinger E (1990) Activity of tetrazepam in low back pain. Clin Trials J 27:58–67
3.
Zurück zum Zitat Assendelft WJ, Morton SC, Yu EI, Suttorp MJ, Shekelle PG (2004) Spinal manipulative therapy for low back pain. Cochrane Database Syst Rev CD000447 Assendelft WJ, Morton SC, Yu EI, Suttorp MJ, Shekelle PG (2004) Spinal manipulative therapy for low back pain. Cochrane Database Syst Rev CD000447
4.
Zurück zum Zitat Aure OF, Nilsen JH, Vasseljen O (2003) Manual therapy and exercise therapy in patients with chronic low back pain: a randomized, controlled trial with 1-year follow-up. Spine 28:525–531; discussion 531–522 Aure OF, Nilsen JH, Vasseljen O (2003) Manual therapy and exercise therapy in patients with chronic low back pain: a randomized, controlled trial with 1-year follow-up. Spine 28:525–531; discussion 531–522
5.
Zurück zum Zitat Babej-Dolle R, Freytag S, Eckmeyer J, Zerle G, Schinzel S, Schmeider G, Stankov G (1994) Parenteral dipyrone versus diclofenac and placebo in patients with acute lumbago or sciatic pain: randomized observer-blind multicenter study. Int J Clin Pharmacol Ther 32:204–209PubMed Babej-Dolle R, Freytag S, Eckmeyer J, Zerle G, Schinzel S, Schmeider G, Stankov G (1994) Parenteral dipyrone versus diclofenac and placebo in patients with acute lumbago or sciatic pain: randomized observer-blind multicenter study. Int J Clin Pharmacol Ther 32:204–209PubMed
6.
Zurück zum Zitat Barrata R (1982) A double-blind study of cyclobenzaprine and placebo in the treatment of acute musculoskeletal conditions of the low back pain. Curr Ther Res 32:646–652 Barrata R (1982) A double-blind study of cyclobenzaprine and placebo in the treatment of acute musculoskeletal conditions of the low back pain. Curr Ther Res 32:646–652
7.
Zurück zum Zitat Bendix AF, Bendix T, Lund C, Kirkbak S, Ostenfeld S (1997) Comparison of three intensive programs for chronic low back pain patients: a prospective, randomized, observer-blinded study with one- year follow-up. Scand J Rehabil Med 29:81–89PubMed Bendix AF, Bendix T, Lund C, Kirkbak S, Ostenfeld S (1997) Comparison of three intensive programs for chronic low back pain patients: a prospective, randomized, observer-blinded study with one- year follow-up. Scand J Rehabil Med 29:81–89PubMed
8.
Zurück zum Zitat Bergquist-Ullman M, Larsson U (1977) Acute low back pain in industry. A controlled prospective study with special reference to therapy and confounding factors. Acta Orthop Scand 1–117 Bergquist-Ullman M, Larsson U (1977) Acute low back pain in industry. A controlled prospective study with special reference to therapy and confounding factors. Acta Orthop Scand 1–117
9.
Zurück zum Zitat Berry H, Hutchinson D (1988) A multicenter placebo-controlled study in general practice to evaluate the efficacy and safety of tizanidine in acute low-back pain. J Int Med Res 16:75–82PubMed Berry H, Hutchinson D (1988) A multicenter placebo-controlled study in general practice to evaluate the efficacy and safety of tizanidine in acute low-back pain. J Int Med Res 16:75–82PubMed
10.
Zurück zum Zitat Birbara CA, Puopolo AD, Munoz DR, Sheldon EA, Mangione A, Bohidar NR, Geba GP (2003) Treatment of chronic low back pain with etoricoxib, a new cyclo-oxygenase-2 selective inhibitor: improvement in pain and disability—a randomized, placebo-controlled, 3-month trial. J Pain 4:307–315PubMedCrossRef Birbara CA, Puopolo AD, Munoz DR, Sheldon EA, Mangione A, Bohidar NR, Geba GP (2003) Treatment of chronic low back pain with etoricoxib, a new cyclo-oxygenase-2 selective inhibitor: improvement in pain and disability—a randomized, placebo-controlled, 3-month trial. J Pain 4:307–315PubMedCrossRef
11.
Zurück zum Zitat Bombardier C (2000) Outcome assessments in the evaluation of treatment of spinal disorders: summary and general recommendations. Spine 25:3100–3103PubMedCrossRef Bombardier C (2000) Outcome assessments in the evaluation of treatment of spinal disorders: summary and general recommendations. Spine 25:3100–3103PubMedCrossRef
12.
Zurück zum Zitat Carlsson CP, Sjolund BH (2001) Acupuncture for chronic low back pain: a randomized placebo-controlled study with long-term follow-up. Clin J Pain 17:296–305PubMedCrossRef Carlsson CP, Sjolund BH (2001) Acupuncture for chronic low back pain: a randomized placebo-controlled study with long-term follow-up. Clin J Pain 17:296–305PubMedCrossRef
13.
Zurück zum Zitat Chok B, Lee R, Latimer J, Tan SB (1999) Endurance training of the trunk extensor muscles in people with subacute low back pain. Phys Ther 79:1032–1042PubMed Chok B, Lee R, Latimer J, Tan SB (1999) Endurance training of the trunk extensor muscles in people with subacute low back pain. Phys Ther 79:1032–1042PubMed
14.
Zurück zum Zitat Coan RM, Wong G, Ku SL, Chan YC, Wang L, Ozer FT, Coan PL (1980) The acupuncture treatment of low back pain: a randomized controlled study. Am J Chin Med 8:181–189PubMedCrossRef Coan RM, Wong G, Ku SL, Chan YC, Wang L, Ozer FT, Coan PL (1980) The acupuncture treatment of low back pain: a randomized controlled study. Am J Chin Med 8:181–189PubMedCrossRef
15.
Zurück zum Zitat Coats TL, Borenstein DG, Nangia NK, Brown MT (2004) Effects of valdecoxib in the treatment of chronic low back pain: results of a randomized, placebo-controlled trial. Clin Ther 26:1249–1260PubMedCrossRef Coats TL, Borenstein DG, Nangia NK, Brown MT (2004) Effects of valdecoxib in the treatment of chronic low back pain: results of a randomized, placebo-controlled trial. Clin Ther 26:1249–1260PubMedCrossRef
16.
Zurück zum Zitat Cohen J (1977) Statistical power analysis for the behavioral sciences. Academic, New York Cohen J (1977) Statistical power analysis for the behavioral sciences. Academic, New York
17.
Zurück zum Zitat Deyo RA, Walsh NE, Martin DC, Schoenfeld LS, Ramamurthy S (1990) A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain. N Engl J Med 322:1627–1634PubMedCrossRef Deyo RA, Walsh NE, Martin DC, Schoenfeld LS, Ramamurthy S (1990) A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain. N Engl J Med 322:1627–1634PubMedCrossRef
18.
Zurück zum Zitat Dreiser RL, Marty M, Ionescu E, Gold M, Liu JH (2003) Relief of acute low back pain with diclofenac-K 12.5 mg tablets: a flexible dose, ibuprofen 200 mg and placebo-controlled clinical trial. Int J Clin Pharmacol Ther 41:375–385PubMed Dreiser RL, Marty M, Ionescu E, Gold M, Liu JH (2003) Relief of acute low back pain with diclofenac-K 12.5 mg tablets: a flexible dose, ibuprofen 200 mg and placebo-controlled clinical trial. Int J Clin Pharmacol Ther 41:375–385PubMed
19.
Zurück zum Zitat Egger M, Smith G, Altman DG (2001) Systematic reviews in health care. Meta-analysis in context. BMJ Books, London Egger M, Smith G, Altman DG (2001) Systematic reviews in health care. Meta-analysis in context. BMJ Books, London
20.
Zurück zum Zitat European Commission COST B13 Management Committee (2002) European guidelines for the management of low back pain. Acta Orthop Scand Suppl 73:20–25 European Commission COST B13 Management Committee (2002) European guidelines for the management of low back pain. Acta Orthop Scand Suppl 73:20–25
21.
Zurück zum Zitat Evans DP, Burke MS, Lloyd KN, Roberts EE, Roberts GM (1978) Lumbar spinal manipulation on trial. Part I—clinical assessment. Rheumatol Rehabil 17:46–53PubMedCrossRef Evans DP, Burke MS, Lloyd KN, Roberts EE, Roberts GM (1978) Lumbar spinal manipulation on trial. Part I—clinical assessment. Rheumatol Rehabil 17:46–53PubMedCrossRef
22.
Zurück zum Zitat Fritzell P, Hagg O, Wessberg P, Nordwall A (2001) 2001 Volvo award winner in clinical studies: lumbar fusion versus nonsurgical treatment for chronic low back pain: a multicenter randomized controlled trial from the Swedish lumbar spine study group. Spine 26:2521–2532; discussion 2532–2524 Fritzell P, Hagg O, Wessberg P, Nordwall A (2001) 2001 Volvo award winner in clinical studies: lumbar fusion versus nonsurgical treatment for chronic low back pain: a multicenter randomized controlled trial from the Swedish lumbar spine study group. Spine 26:2521–2532; discussion 2532–2524
23.
Zurück zum Zitat Furlan AD, Brosseau L, Imamura M, Irvin E (2002) Massage for low back pain. Cochrane Database Syst Rev CD001929 Furlan AD, Brosseau L, Imamura M, Irvin E (2002) Massage for low back pain. Cochrane Database Syst Rev CD001929
24.
Zurück zum Zitat Furlan AD, van Tulder MW, Cherkin DC, Tsukayama H, Lao L, Koes BW, Berman BM (2005) Acupuncture and dry-needling for low back pain. Cochrane Database Syst Rev CD001351 Furlan AD, van Tulder MW, Cherkin DC, Tsukayama H, Lao L, Koes BW, Berman BM (2005) Acupuncture and dry-needling for low back pain. Cochrane Database Syst Rev CD001351
25.
Zurück zum Zitat Furukawa TA, Barbui C, Cipriani A, Brambilla P, Watanabe N (2006) Imputing missing standard deviations in meta-analyses can provide accurate results. J Clin Epidemiol 59:7–10PubMedCrossRef Furukawa TA, Barbui C, Cipriani A, Brambilla P, Watanabe N (2006) Imputing missing standard deviations in meta-analyses can provide accurate results. J Clin Epidemiol 59:7–10PubMedCrossRef
26.
Zurück zum Zitat Faas A, Chavannes AW, van Eijk JT, Gubbels JW (1993) A randomized, placebo-controlled trial of exercise therapy in patients with acute low back pain. Spine 18:1388–1395PubMed Faas A, Chavannes AW, van Eijk JT, Gubbels JW (1993) A randomized, placebo-controlled trial of exercise therapy in patients with acute low back pain. Spine 18:1388–1395PubMed
27.
Zurück zum Zitat Gibson JN, Grant IC, Waddell G (2000) Surgery for lumbar disc prolapse. Cochrane Database Syst Rev CD001350 Gibson JN, Grant IC, Waddell G (2000) Surgery for lumbar disc prolapse. Cochrane Database Syst Rev CD001350
28.
Zurück zum Zitat Gibson JN, Waddell G, Grant IC (2000) Surgery for degenerative lumbar spondylosis. Cochrane Database Syst Rev CD001352 Gibson JN, Waddell G, Grant IC (2000) Surgery for degenerative lumbar spondylosis. Cochrane Database Syst Rev CD001352
29.
Zurück zum Zitat Glover JR, Morris JG, Khosla T (1974) Back pain: a randomized clinical trial of rotational manipulation of the trunk. Br J Ind Med 31:59–64PubMed Glover JR, Morris JG, Khosla T (1974) Back pain: a randomized clinical trial of rotational manipulation of the trunk. Br J Ind Med 31:59–64PubMed
30.
Zurück zum Zitat Guzman J, Esmail R, Karjalainen K, Malmivaara A, Irvin E, Bombardier C (2002) Multidisciplinary bio-psycho-social rehabilitation for chronic low back pain. Cochrane Database Syst Rev CD000963 Guzman J, Esmail R, Karjalainen K, Malmivaara A, Irvin E, Bombardier C (2002) Multidisciplinary bio-psycho-social rehabilitation for chronic low back pain. Cochrane Database Syst Rev CD000963
31.
Zurück zum Zitat Hagen K, Hilde G, Jamtvedt G, Winnem M (2004) Bed rest for acute low-back pain and sciatica. Cochrane Database Syst Rev CD001254 Hagen K, Hilde G, Jamtvedt G, Winnem M (2004) Bed rest for acute low-back pain and sciatica. Cochrane Database Syst Rev CD001254
32.
Zurück zum Zitat Hayden JA, van Tulder MW, Malmivaara AV, Koes BW (2005) Meta-analysis: exercise therapy for nonspecific low back pain. Ann Intern Med 142:765–775PubMed Hayden JA, van Tulder MW, Malmivaara AV, Koes BW (2005) Meta-analysis: exercise therapy for nonspecific low back pain. Ann Intern Med 142:765–775PubMed
33.
Zurück zum Zitat Heymans M, Tulder M, Esmail R, Bombardier C, Koes B (2004) Back schools for non-specific low-back pain. Cochrane Database Syst Rev CD000261 Heymans M, Tulder M, Esmail R, Bombardier C, Koes B (2004) Back schools for non-specific low-back pain. Cochrane Database Syst Rev CD000261
34.
Zurück zum Zitat Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560PubMedCrossRef Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560PubMedCrossRef
35.
Zurück zum Zitat Hilde G, Hagen KB, Jamtvedt G, Winnem M (2002) Advice to stay active as a single treatment for low back pain and sciatica. Cochrane Database Syst Rev CD003632 Hilde G, Hagen KB, Jamtvedt G, Winnem M (2002) Advice to stay active as a single treatment for low back pain and sciatica. Cochrane Database Syst Rev CD003632
36.
Zurück zum Zitat Hurley DA, McDonough SM, Dempster M, Moore AP, Baxter GD (2004) A randomized clinical trial of manipulative therapy and interferential therapy for acute low back pain. Spine 29:2207–2216PubMedCrossRef Hurley DA, McDonough SM, Dempster M, Moore AP, Baxter GD (2004) A randomized clinical trial of manipulative therapy and interferential therapy for acute low back pain. Spine 29:2207–2216PubMedCrossRef
37.
Zurück zum Zitat Indahl A (2004) Low back pain: diagnosis, treatment, and prognosis. Scand J Rheumatol 33:199–209PubMedCrossRef Indahl A (2004) Low back pain: diagnosis, treatment, and prognosis. Scand J Rheumatol 33:199–209PubMedCrossRef
38.
Zurück zum Zitat Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17:1–12PubMedCrossRef Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17:1–12PubMedCrossRef
39.
Zurück zum Zitat Karjalainen K, Malmivaara A, van Tulder M, Roine R, Jauhiainen M, Hurri H, Koes B (2003) Multidisciplinary biopsychosocial rehabilitation for subacute low back pain among working age adults. Cochrane Database Syst Rev CD002193 Karjalainen K, Malmivaara A, van Tulder M, Roine R, Jauhiainen M, Hurri H, Koes B (2003) Multidisciplinary biopsychosocial rehabilitation for subacute low back pain among working age adults. Cochrane Database Syst Rev CD002193
40.
Zurück zum Zitat Katz N, Ju WD, Krupa DA, Sperling RS, Bozalis Rodgers D, Gertz BJ, Gimbel J, Coleman S, Fisher C, Nabizadeh S, Borenstein D (2003) Efficacy and safety of rofecoxib in patients with chronic low back pain: results from two 4-week, randomized, placebo-controlled, parallel-group, double-blind trials. Spine 28:851–858; discussion 859 Katz N, Ju WD, Krupa DA, Sperling RS, Bozalis Rodgers D, Gertz BJ, Gimbel J, Coleman S, Fisher C, Nabizadeh S, Borenstein D (2003) Efficacy and safety of rofecoxib in patients with chronic low back pain: results from two 4-week, randomized, placebo-controlled, parallel-group, double-blind trials. Spine 28:851–858; discussion 859
41.
Zurück zum Zitat Kazis LE, Anderson JJ, Meenan RF (1989) Effect sizes for interpreting changes in health status. Med Care 27:S178–S189PubMedCrossRef Kazis LE, Anderson JJ, Meenan RF (1989) Effect sizes for interpreting changes in health status. Med Care 27:S178–S189PubMedCrossRef
42.
Zurück zum Zitat Kerr DP, Walsh DM, Baxter GD (2001) A study of the use of acupuncture in physiotherapy. Complement Ther Med 9:21–27PubMedCrossRef Kerr DP, Walsh DM, Baxter GD (2001) A study of the use of acupuncture in physiotherapy. Complement Ther Med 9:21–27PubMedCrossRef
43.
Zurück zum Zitat Khadilkar A, Milne S, Brosseau L, Wells G, Tugwell P, Robinson V, Shea B, Saginur M (2005) Transcutaneous electrical nerve stimulation for the treatment of chronic low back pain: a systematic review. Spine 30:2657–2666PubMedCrossRef Khadilkar A, Milne S, Brosseau L, Wells G, Tugwell P, Robinson V, Shea B, Saginur M (2005) Transcutaneous electrical nerve stimulation for the treatment of chronic low back pain: a systematic review. Spine 30:2657–2666PubMedCrossRef
44.
Zurück zum Zitat Kopec JA (2000) Measuring functional outcomes in persons with back pain: a review of back-specific questionnaires. Spine 25:3110–3114PubMedCrossRef Kopec JA (2000) Measuring functional outcomes in persons with back pain: a review of back-specific questionnaires. Spine 25:3110–3114PubMedCrossRef
45.
Zurück zum Zitat Kuukkanen T, Malkia E (2000) Effects of a three-month therapeutic exercise programme on flexibility in subjects with low back pain. Physiother Res Int 5:46–61PubMedCrossRef Kuukkanen T, Malkia E (2000) Effects of a three-month therapeutic exercise programme on flexibility in subjects with low back pain. Physiother Res Int 5:46–61PubMedCrossRef
46.
Zurück zum Zitat Leibing E, Leonhardt U, Koster G, Goerlitz A, Rosenfeldt JA, Hilgers R, Ramadori G (2002) Acupuncture treatment of chronic low-back pain—a randomized, blinded, placebo-controlled trial with 9-month follow-up. Pain 96:189–196PubMedCrossRef Leibing E, Leonhardt U, Koster G, Goerlitz A, Rosenfeldt JA, Hilgers R, Ramadori G (2002) Acupuncture treatment of chronic low-back pain—a randomized, blinded, placebo-controlled trial with 9-month follow-up. Pain 96:189–196PubMedCrossRef
47.
Zurück zum Zitat Lepisto P (1979) A comparative trial of DS 103–282 and placebo in the treatment of acute skeletal muscle spasms due to disorders of the back. Ther Res 26:454–459 Lepisto P (1979) A comparative trial of DS 103–282 and placebo in the treatment of acute skeletal muscle spasms due to disorders of the back. Ther Res 26:454–459
48.
Zurück zum Zitat Licciardone JC, Stoll ST, Fulda KG, Russo DP, Siu J, Winn W, Swift J Jr (2003) Osteopathic manipulative treatment for chronic low back pain: a randomized controlled trial. Spine 28:1355–1362PubMedCrossRef Licciardone JC, Stoll ST, Fulda KG, Russo DP, Siu J, Winn W, Swift J Jr (2003) Osteopathic manipulative treatment for chronic low back pain: a randomized controlled trial. Spine 28:1355–1362PubMedCrossRef
49.
Zurück zum Zitat Linton SJ, Bradley LA, Jensen I, Spangfort E, Sundell L (1989) The secondary prevention of low back pain: a controlled study with follow-up. Pain 36:197–207PubMedCrossRef Linton SJ, Bradley LA, Jensen I, Spangfort E, Sundell L (1989) The secondary prevention of low back pain: a controlled study with follow-up. Pain 36:197–207PubMedCrossRef
50.
Zurück zum Zitat Malmivaara A, Hakkinen U, Aro T, Heinrichs ML, Koskenniemi L, Kuosma E, Lappi S, Paloheimo R, Servo C, Vaaranen V, et al (1995) The treatment of acute low back pain—bed rest, exercises, or ordinary activity? N Engl J Med 332:351–355PubMedCrossRef Malmivaara A, Hakkinen U, Aro T, Heinrichs ML, Koskenniemi L, Kuosma E, Lappi S, Paloheimo R, Servo C, Vaaranen V, et al (1995) The treatment of acute low back pain—bed rest, exercises, or ordinary activity? N Engl J Med 332:351–355PubMedCrossRef
51.
Zurück zum Zitat Mannion AF, Junge A, Taimela S, Muntener M, Lorenzo K, Dvorak J (2001) Active therapy for chronic low back pain: part 3. Factors influencing self-rated disability and its change following therapy. Spine 26:920–929PubMedCrossRef Mannion AF, Junge A, Taimela S, Muntener M, Lorenzo K, Dvorak J (2001) Active therapy for chronic low back pain: part 3. Factors influencing self-rated disability and its change following therapy. Spine 26:920–929PubMedCrossRef
52.
Zurück zum Zitat Mannion AF, Muntener M, Taimela S, Dvorak J (1999) A randomized clinical trial of three active therapies for chronic low back pain. Spine 24:2435–2448PubMedCrossRef Mannion AF, Muntener M, Taimela S, Dvorak J (1999) A randomized clinical trial of three active therapies for chronic low back pain. Spine 24:2435–2448PubMedCrossRef
53.
Zurück zum Zitat Marchand S, Charest J, Li J, Chenard JR, Lavignolle B, Laurencelle L (1993) Is TENS purely a placebo effect? A controlled study on chronic low back pain. Pain 54:99–106PubMedCrossRef Marchand S, Charest J, Li J, Chenard JR, Lavignolle B, Laurencelle L (1993) Is TENS purely a placebo effect? A controlled study on chronic low back pain. Pain 54:99–106PubMedCrossRef
54.
Zurück zum Zitat Mayer JM, Ralph L, Look M, Erasala GN, Verna JL, Matheson LN, Mooney V (2005) Treating acute low back pain with continuous low-level heat wrap therapy and/or exercise: a randomized controlled trial. Spine J 5:395–403PubMedCrossRef Mayer JM, Ralph L, Look M, Erasala GN, Verna JL, Matheson LN, Mooney V (2005) Treating acute low back pain with continuous low-level heat wrap therapy and/or exercise: a randomized controlled trial. Spine J 5:395–403PubMedCrossRef
55.
Zurück zum Zitat Mendelson G, Selwood TS, Kranz H, Loh TS, Kidson MA, Scott DS (1983) Acupuncture treatment of chronic back pain. A double-blind placebo-controlled trial. Am J Med 74:49–55PubMedCrossRef Mendelson G, Selwood TS, Kranz H, Loh TS, Kidson MA, Scott DS (1983) Acupuncture treatment of chronic back pain. A double-blind placebo-controlled trial. Am J Med 74:49–55PubMedCrossRef
56.
Zurück zum Zitat Mitchell RI, Carmen GM (1990) Results of a multicenter trial using an intensive active exercise program for the treatment of acute soft tissue and back injuries. Spine 15:514–521PubMedCrossRef Mitchell RI, Carmen GM (1990) Results of a multicenter trial using an intensive active exercise program for the treatment of acute soft tissue and back injuries. Spine 15:514–521PubMedCrossRef
57.
Zurück zum Zitat Molsberger AF, Mau J, Pawelec DB, Winkler J (2002) Does acupuncture improve the orthopedic management of chronic low back pain—a randomized, blinded, controlled trial with 3 months follow up. Pain 99:579–587PubMedCrossRef Molsberger AF, Mau J, Pawelec DB, Winkler J (2002) Does acupuncture improve the orthopedic management of chronic low back pain—a randomized, blinded, controlled trial with 3 months follow up. Pain 99:579–587PubMedCrossRef
58.
Zurück zum Zitat Nelemans PJ, de Bie RA, de Vet HC, Sturmans F (2000) Injection therapy for subacute and chronic benign low back pain. Cochrane Database Syst Rev CD001824 Nelemans PJ, de Bie RA, de Vet HC, Sturmans F (2000) Injection therapy for subacute and chronic benign low back pain. Cochrane Database Syst Rev CD001824
59.
Zurück zum Zitat Niemisto L, Lahtinen-Suopanki T, Rissanen P, Lindgren KA, Sarna S, Hurri H (2003) A randomized trial of combined manipulation, stabilizing exercises, and physician consultation compared to physician consultation alone for chronic low back pain. Spine 28:2185–2191PubMedCrossRef Niemisto L, Lahtinen-Suopanki T, Rissanen P, Lindgren KA, Sarna S, Hurri H (2003) A randomized trial of combined manipulation, stabilizing exercises, and physician consultation compared to physician consultation alone for chronic low back pain. Spine 28:2185–2191PubMedCrossRef
60.
Zurück zum Zitat Nouwen A (1983) EMG biofeedback used to reduce standing levels of paraspinal muscle tension in chronic low back pain. Pain 17:353–360PubMedCrossRef Nouwen A (1983) EMG biofeedback used to reduce standing levels of paraspinal muscle tension in chronic low back pain. Pain 17:353–360PubMedCrossRef
61.
Zurück zum Zitat Ongley MJ, Klein RG, Dorman TA, Eek BC, Hubert LJ (1987) A new approach to the treatment of chronic low back pain. Lancet 2:143–146PubMedCrossRef Ongley MJ, Klein RG, Dorman TA, Eek BC, Hubert LJ (1987) A new approach to the treatment of chronic low back pain. Lancet 2:143–146PubMedCrossRef
62.
Zurück zum Zitat Pallay RM, Seger W, Adler JL, Ettlinger RE, Quaidoo EA, Lipetz R, O’Brien K, Mucciola L, Skalky CS, Petruschke RA, Bohidar NR, Geba GP (2004) Etoricoxib reduced pain and disability and improved quality of life in patients with chronic low back pain: a 3 month, randomized, controlled trial. Scand J Rheumatol 33:257–266PubMedCrossRef Pallay RM, Seger W, Adler JL, Ettlinger RE, Quaidoo EA, Lipetz R, O’Brien K, Mucciola L, Skalky CS, Petruschke RA, Bohidar NR, Geba GP (2004) Etoricoxib reduced pain and disability and improved quality of life in patients with chronic low back pain: a 3 month, randomized, controlled trial. Scand J Rheumatol 33:257–266PubMedCrossRef
63.
Zurück zum Zitat Postacchini F, Facchini M, Palieri P (1988) Efficacy of various forms of conservative treatment in low back pain. A comparative study. Neuro Orthop 6:28–35 Postacchini F, Facchini M, Palieri P (1988) Efficacy of various forms of conservative treatment in low back pain. A comparative study. Neuro Orthop 6:28–35
64.
Zurück zum Zitat Preyde M (2000) Effectiveness of massage therapy for subacute low-back pain: a randomized controlled trial. CMAJ 162:1815–1820PubMed Preyde M (2000) Effectiveness of massage therapy for subacute low-back pain: a randomized controlled trial. CMAJ 162:1815–1820PubMed
65.
Zurück zum Zitat Risch SV, Norvell NK, Pollock ML, Risch ED, Langer H, Fulton M, Graves JE, Leggett SH (1993) Lumbar strengthening in chronic low back pain patients. Physiologic and psychological benefits. Spine 18:232–238PubMedCrossRef Risch SV, Norvell NK, Pollock ML, Risch ED, Langer H, Fulton M, Graves JE, Leggett SH (1993) Lumbar strengthening in chronic low back pain patients. Physiologic and psychological benefits. Spine 18:232–238PubMedCrossRef
66.
Zurück zum Zitat Salzmann E, Pforringer W, Paal G, et al (1992) Treatment of chronic low-back syndrome with tetrazepamin a placebo controlled double-blind trial. J Drug Dev 4:219–228 Salzmann E, Pforringer W, Paal G, et al (1992) Treatment of chronic low-back syndrome with tetrazepamin a placebo controlled double-blind trial. J Drug Dev 4:219–228
67.
Zurück zum Zitat Schonstein E, Kenny DT, Keating J, Koes BW (2003) Work conditioning, work hardening and functional restoration for workers with back and neck pain. Cochrane Database Syst Rev CD001822 Schonstein E, Kenny DT, Keating J, Koes BW (2003) Work conditioning, work hardening and functional restoration for workers with back and neck pain. Cochrane Database Syst Rev CD001822
68.
Zurück zum Zitat Sherman KJ, Cherkin DC, Erro J, Miglioretti DL, Deyo RA (2005) Comparing yoga, exercise, and a self-care book for chronic low back pain: a randomized, controlled trial. Ann Intern Med 143:849–856PubMed Sherman KJ, Cherkin DC, Erro J, Miglioretti DL, Deyo RA (2005) Comparing yoga, exercise, and a self-care book for chronic low back pain: a randomized, controlled trial. Ann Intern Med 143:849–856PubMed
69.
Zurück zum Zitat Soukup MG, Glomsrod B, Lonn JH, Bo K, Larsen S (1999) The effect of a Mensendieck exercise program as secondary prophylaxis for recurrent low back pain. A randomized, controlled trial with 12-month follow-up. Spine 24:1585–1591; discussion 1592 Soukup MG, Glomsrod B, Lonn JH, Bo K, Larsen S (1999) The effect of a Mensendieck exercise program as secondary prophylaxis for recurrent low back pain. A randomized, controlled trial with 12-month follow-up. Spine 24:1585–1591; discussion 1592
70.
Zurück zum Zitat Stuckey SJ, Jacobs A, Goldfarb J (1986) EMG biofeedback training, relaxation training, and placebo for the relief of chronic back pain. Percept Mot Skills 63:1023–1036PubMed Stuckey SJ, Jacobs A, Goldfarb J (1986) EMG biofeedback training, relaxation training, and placebo for the relief of chronic back pain. Percept Mot Skills 63:1023–1036PubMed
71.
Zurück zum Zitat Szpalski M, Hayez JP (1994) Objective functional assessment of the efficacy of tenoxicam in the treatment of acute low back pain. A double-blind placebo-controlled study. Br J Rheumatol 33:74–78PubMedCrossRef Szpalski M, Hayez JP (1994) Objective functional assessment of the efficacy of tenoxicam in the treatment of acute low back pain. A double-blind placebo-controlled study. Br J Rheumatol 33:74–78PubMedCrossRef
72.
Zurück zum Zitat Thomas M, Lundberg T (1994) Importance of modes of acupuncture in the treatment of chronic nociceptive low back pain. Acta Anaesthesiol Scand 38:63–69PubMedCrossRef Thomas M, Lundberg T (1994) Importance of modes of acupuncture in the treatment of chronic nociceptive low back pain. Acta Anaesthesiol Scand 38:63–69PubMedCrossRef
73.
Zurück zum Zitat Triano JJ, McGregor M, Hondras MA, Brennan PC (1995) Manipulative therapy versus education programs in chronic low back pain. Spine 20:948–955PubMedCrossRef Triano JJ, McGregor M, Hondras MA, Brennan PC (1995) Manipulative therapy versus education programs in chronic low back pain. Spine 20:948–955PubMedCrossRef
74.
Zurück zum Zitat Turner JA, Chapman CR (1982) Psychological interventions for chronic pain: a critical review I. Relaxation training and biofeedback. Pain 12:1–21PubMedCrossRef Turner JA, Chapman CR (1982) Psychological interventions for chronic pain: a critical review I. Relaxation training and biofeedback. Pain 12:1–21PubMedCrossRef
75.
Zurück zum Zitat Turner JA, Clancy S (1988) Comparison of operant behavioral and cognitive-behavioral group treatment for chronic low back pain. J Consult Clin Psychol 56:261–266PubMedCrossRef Turner JA, Clancy S (1988) Comparison of operant behavioral and cognitive-behavioral group treatment for chronic low back pain. J Consult Clin Psychol 56:261–266PubMedCrossRef
76.
Zurück zum Zitat Turner JA, Clancy S, McQuade KJ, Cardenas DD (1990) Effectiveness of behavioral therapy for chronic low back pain: a component analysis. J Consult Clin Psychol 58:573–579PubMedCrossRef Turner JA, Clancy S, McQuade KJ, Cardenas DD (1990) Effectiveness of behavioral therapy for chronic low back pain: a component analysis. J Consult Clin Psychol 58:573–579PubMedCrossRef
77.
Zurück zum Zitat Turner JA, Jensen MP (1993) Efficacy of cognitive therapy for chronic low back pain. Pain 52:169–177PubMedCrossRef Turner JA, Jensen MP (1993) Efficacy of cognitive therapy for chronic low back pain. Pain 52:169–177PubMedCrossRef
78.
Zurück zum Zitat Tuzun F, Unalan H, Oner N, Ozguzel H, Kirazli Y, Icagasioglu A, Kuran B, Tuzun S, Basar G (2003) Multicenter, randomized, double-blinded, placebo-controlled trial of thiocolchicoside in acute low back pain. Joint Bone Spine 70:356–361PubMedCrossRef Tuzun F, Unalan H, Oner N, Ozguzel H, Kirazli Y, Icagasioglu A, Kuran B, Tuzun S, Basar G (2003) Multicenter, randomized, double-blinded, placebo-controlled trial of thiocolchicoside in acute low back pain. Joint Bone Spine 70:356–361PubMedCrossRef
79.
Zurück zum Zitat Urrutia G, Burton AK, Morral A, Bonfill X, Zanoli G (2004) Neuroreflexotherapy for non-specific low-back pain. Cochrane Database Syst Rev CD003009 Urrutia G, Burton AK, Morral A, Bonfill X, Zanoli G (2004) Neuroreflexotherapy for non-specific low-back pain. Cochrane Database Syst Rev CD003009
80.
Zurück zum Zitat van Tulder M, Furlan A, Bombardier C, Bouter L (2003) Updated method guidelines for systematic reviews in the cochrane collaboration back review group. Spine 28:1290–1299PubMedCrossRef van Tulder M, Furlan A, Bombardier C, Bouter L (2003) Updated method guidelines for systematic reviews in the cochrane collaboration back review group. Spine 28:1290–1299PubMedCrossRef
81.
Zurück zum Zitat van Tulder M, Malmivaara A, Esmail R, Koes B (2002) Exercise therapy for low back pain: a systematic review within the framework of the cochrane collaboration back review group. Spine 25:2784–2796CrossRef van Tulder M, Malmivaara A, Esmail R, Koes B (2002) Exercise therapy for low back pain: a systematic review within the framework of the cochrane collaboration back review group. Spine 25:2784–2796CrossRef
82.
Zurück zum Zitat van Tulder MW, Jellema P, van Poppel MN, Nachemson AL, Bouter LM (2000) Lumbar supports for prevention and treatment of low back pain. Cochrane Database Syst Rev CD001823 van Tulder MW, Jellema P, van Poppel MN, Nachemson AL, Bouter LM (2000) Lumbar supports for prevention and treatment of low back pain. Cochrane Database Syst Rev CD001823
83.
Zurück zum Zitat van Tulder MW, Ostelo R, Vlaeyen JW, Linton SJ, Morley SJ, Assendelft WJ (2000) Behavioral treatment for chronic low back pain: a systematic review within the framework of the cochrane back review group. Spine 25:2688–2699PubMedCrossRef van Tulder MW, Ostelo R, Vlaeyen JW, Linton SJ, Morley SJ, Assendelft WJ (2000) Behavioral treatment for chronic low back pain: a systematic review within the framework of the cochrane back review group. Spine 25:2688–2699PubMedCrossRef
84.
Zurück zum Zitat van Tulder MW, Scholten RJ, Koes BW, Deyo RA (2000) Non-steroidal anti-inflammatory drugs for low back pain. Cochrane Database Syst Rev CD000396 van Tulder MW, Scholten RJ, Koes BW, Deyo RA (2000) Non-steroidal anti-inflammatory drugs for low back pain. Cochrane Database Syst Rev CD000396
85.
Zurück zum Zitat van Tulder MW, Touray T, Furlan AD, Solway S, Bouter LM (2003) Muscle relaxants for non-specific low back pain. Cochrane Database Syst Rev CD004252 van Tulder MW, Touray T, Furlan AD, Solway S, Bouter LM (2003) Muscle relaxants for non-specific low back pain. Cochrane Database Syst Rev CD004252
86.
Zurück zum Zitat Von Korff M, Jensen MP, Karoly P (2000) Assessing global pain severity by self-report in clinical and health services research. Spine 25:3140–3151CrossRef Von Korff M, Jensen MP, Karoly P (2000) Assessing global pain severity by self-report in clinical and health services research. Spine 25:3140–3151CrossRef
87.
Zurück zum Zitat Waddell G (1987) 1987 Volvo award in clinical sciences. A new clinical model for the treatment of low-back pain. Spine 12:632–644PubMedCrossRef Waddell G (1987) 1987 Volvo award in clinical sciences. A new clinical model for the treatment of low-back pain. Spine 12:632–644PubMedCrossRef
88.
Zurück zum Zitat Wand BM, Bird C, McAuley JH, Dore CJ, MacDowell M, De Souza LH (2004) Early intervention for the management of acute low back pain: a single-blind randomized controlled trial of biopsychosocial education, manual therapy, and exercise. Spine 29:2350–2356PubMedCrossRef Wand BM, Bird C, McAuley JH, Dore CJ, MacDowell M, De Souza LH (2004) Early intervention for the management of acute low back pain: a single-blind randomized controlled trial of biopsychosocial education, manual therapy, and exercise. Spine 29:2350–2356PubMedCrossRef
89.
Zurück zum Zitat Waagen G, Haldeman S, Cook G, Lopez D, DeBoer K (1986) Short term trial of chiropractic adjustments for the relief of chronic low back pain. Manual Med 2:63–67 Waagen G, Haldeman S, Cook G, Lopez D, DeBoer K (1986) Short term trial of chiropractic adjustments for the relief of chronic low back pain. Manual Med 2:63–67
90.
Zurück zum Zitat Yelland MJ, Mar C, Pirozzo S, Schoene ML, Vercoe P (2004) Prolotherapy injections for chronic low-back pain. Cochrane Database Syst Rev CD004059 Yelland MJ, Mar C, Pirozzo S, Schoene ML, Vercoe P (2004) Prolotherapy injections for chronic low-back pain. Cochrane Database Syst Rev CD004059
91.
Zurück zum Zitat Zylbergold R, Piper M (1981) Lumbar disc disease: comparative analysis of physical therapy. Arch Phys Med Rehabil 62:176–179PubMed Zylbergold R, Piper M (1981) Lumbar disc disease: comparative analysis of physical therapy. Arch Phys Med Rehabil 62:176–179PubMed
Metadaten
Titel
Effect sizes of non-surgical treatments of non-specific low-back pain
verfasst von
A. Keller
J. Hayden
C. Bombardier
M. van Tulder
Publikationsdatum
01.11.2007
Verlag
Springer-Verlag
Erschienen in
European Spine Journal / Ausgabe 11/2007
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-007-0379-x

Weitere Artikel der Ausgabe 11/2007

European Spine Journal 11/2007 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.