Conservative treatment of nonspecific, chronic low back pain : Evidence of the efficacy - a systematic literature review

Abstract

Non-specific chronic low back pain (NSCLBP): Which conservative therapy shows an evident effectiveness - Areview of the current literature. Our results are based on literature reviews of current randomised control studies, reviews and meta-analysis drawn from the Cochrane Library and Medline-Database between the years 2004 until 2015. German and English Studies were included. We focused on different conservative Treatments of NSCLBP, which are listed at, the NVL-Guidelines. Based on the given evidence we evaluated their effectiveness. As part of the review we identified 4657 Publications, 85 were included in this study. Therapeutic options such as bed rest, TENS, Massage, Spine Supports, Back Schools and Antidepressants showed no evident effectiveness. Injections, NSAR analgesic therapy, Thermotherapy and Opioid analgesic therapy indicated ashort-time effectiveness. Along term success (>6weeks) however, can not be shown. Only the Movement therapy can, in the summation of the included studies, postulate an evident (Evidence LevelI) long-term effect treating NSCLBP. Only afew therapy options indicate asignificant evident effectiveness for treating NSCLBP conservatively. At short notice methods such as injection therapy, thermo-therapy and analgesic therapies with NSAR and/or opioids help coping the acute phase. In the long term only movement therapy seems to provide an evident effectiveness. In the case of therapy-refractory NSCLBP amultimodal therapy should be considered.