Effect of education on non-specific neck and low back pain: a systematic review of randomized controlled trials

Effect of education on non-specific neck and low back pain: A meta-analysis of randomized controlled trials

Effect of education on non-specific neck and low back pain: A meta-analysis of randomized controlled trials

The objective of this thesis was to develop a health literacy questionnaire for predicting non-specific neck pain in office workers. This thesis was divided into four stages: 1) systematic review of randomized control trials to gain insights into the effectiveness of education on the prevention and cure of non-specific neck and low back pain and to identify effective educational content to prevent and treat non-specific neck and low back pain; 2) the development of neck pain-specific health literacy questionnaire; 3) evaluation of the predictive validity of the neck pain-specific health literacy questionnaire; and 4) evaluation of the ability of neck pain-specific health literacy questionnaire to predict duration of recovery from non-specific neck pain in office workers. The results showed that the education programs were not effective in preventing and treating neck pain as well as treating low back pain. Three education topics that may be effective in the prevention and treatment of neck and low back pain were identified, namely, function of the spine, information on activities, and information on coping with the problems. The neck pain-specific health literacy questionnaire comprised six questions, with total score ranging from 0 to 24. The questionnaire had acceptable psychometric properties and can differentiate between office workers with and without non-specific neck pain. The questionnaire had acceptable ability to predict incident non-specific neck pain, but was unable to predict duration of recovery from non-specific neck pain in office workers.

Low back pain

Low back pain

The objective of this thesis was to develop a device for postural change while sitting for the prevention of neck or low back pain in office workers. This thesis was divided into four stages: 1) to evaluate the effects of postural shifting frequency on perceived musculoskeletal discomfort during 1 hour of sitting in healthy office workers; 2) to evaluate the effects of the postural shift intervention on the 12-month incidence of the onset of neck and low back pain in high-risk office workers; 3) to investigate the efficacy of postural shift interventions on recovery duration and recurrence of neck and low back pain among high-risk office workers, and 4) to identify variables that moderate the effects of postural shifts interventions on the development of neck and low back pain in office workers. The finding of the first study showed that a postural shift frequency of 20-30 times/h significantly led to lower perceived discomfort in the neck, shoulder, upper back, and low back compared to a postural shift frequency of 10 times/h during 1 hour of sitting. These findings were used to develop a custom-designed device for postural change while sitting by the author and engineering team. The device consisted of three components: a seat pad, processor, and smartphone application. The device collected sitting behavior data and provided recommended postural shifting by gradually pumping air into various parts of the seat pad. The device had good to excellent validity and consistency. The results of the study two and three revealed that office workers who received the postural shift intervention significantly reduced the 12-month incidence rate, shortened recovery time, and reduced recurrence of neck and low back pain. Finally, the finding of the fourth study showed that workers who worked more hours/day and who endorsed higher levels of psychological work demand gained more benefits from the postural shift intervention regarding the prevention of neck pain development than those in the control group. In addition, the workers who had no lumbar support gained more benefits from the postural shift intervention regarding the prevention of low back pain development than those in the control group.

Lumbar supports are used in the treatment of low back pain patients to make the impairment and disability vanish or decrease. Lumbar supports are also used to prevent the onset of low back pain (primary prevention) or to prevent recurrences of a low back pain episode (secondary prevention). The objective of this systematic review was to assess the effects of lumbar supports for prevention and treatment of non-specific low back pain. We searched the Medline, Cinahl and Current Contents databases and the Cochrane Controlled Trials Register up to September 1999, and the Embase database up to September 1998. We also screened references given in relevant reviews and identified controlled trials, and used Science Citation Index to identify additional controlled trials. Controlled clinical trials that reported on any type of lumbar supports as preventive or therapeutic intervention for non-specific low back pain were included. One author extracted data from the trials considering characteristics of the study population, characteristics of the interventions and the final results for each outcome measure. The author compared these findings to data regarding the same characteristics of the same studies published already in other reviews. The methodological quality was independently assessed by two authors. Because it was not possible to perform a quantitative analysis, a qualitative meta-analysis was performed in which the strength of evidence on the effectiveness of lumbar supports was classified as being strong, moderate, limited or conflicting, and no evidence. Five randomized and two nonrandomized controlled preventive trials and six randomized therapeutic trials were included in our review. Overall the methodological quality of the studies included in our review was rather low. Only four of the thirteen studies scored positive on 50% or more of the the internal validity items. There was moderate evidence that for primary prevention lumbar supports are not more effective than other types of treatment or no intervention. No evidence was found on the effectiveness of lumbar supports for secondary prevention. The systematic review of therapeutic trials showed that there is limited evidence that lumbar supports are more effective than no treatment, while it is still unclear if lumbar supports are more effective than other interventions for treatment of low back pain. There is still a need for high quality randomised trials on the effectiveness of lumbar supports. One of the most essential issues to tackle in these future trials seems to be the realisation of an adequate compliance.

A systematic review of randomized and nonrandomized controlled trials. Lumbar supports are used in the treatment of low back pain, but also to prevent the onset (primary prevention) or recurrences of a low back pain episode (secondary prevention). To assess the effects of lumbar sup-ports for prevention and treatment of nonspecific low back pain. The Medline, Cinahl, and Current Contents databases; the Cochrane Controlled Trials Register up to September 1999; and the Embase database up to September 1998 were all searched. References of identified trials and systematic reviews were reviewed and the Science Citation Index used to identify additional trials. Methodologic quality assessment and data extraction were performed by two reviewers independently. A quantitative analysis was performed in which the strength of evidence was classified as strong, moderate, limited or conflicting, and no evidence. Five randomized and two nonrandomized preventive trials and six randomized therapeutic trials were included in the review. Only 4 of the 13 studies were of high quality. There was moderate evidence that lumbar supports are not effective for primary prevention. No evidence was found on the effectiveness of lumbar supports for secondary prevention. The systematic review of therapeutic trials showed that there is limited evidence that lumbar supports are more effective than no treatment, whereas it is still unclear whether lumbar supports are more effective than other interventions for treatment of low back pain. There continues to be a need for high quality randomized trials on the effectiveness of lumbar supports. One of the most essential issues to tackle in these future trials seems to be the realization of adequate compliance.

Low back pain

Low back pain is the most common complaint experienced by the majority of people at some point in their lifetime. Physical therapy has been in favor of effective treatment and prevention of low back pain. However, there is a lack of agreement on the best exercise treatment and abundant studies are in progress. Categorical studies are lacking particularly in this part of the world. This study was designed to compare the effectiveness and efficiency of two specific exercises, core stability exercises with Williams’ flexion exercises, in patients with non-specific low back pain. Objective:The objective of this study was to find out the most effective treatment for patients with non-specific low back pain Methods: This study is a single-blinded randomized clinical trial that was conducted in the physiotherapy outdoor patient department of the public hospital, Jinnah Hospital Lahore (JHL). 20 patients with non-specific low back pain were randomly allocated in two treatment groups, 10 in A (core stability exercises) and 10 in B (Williams’ flexion exercises), after giving informed consent. The conventional treatment of low back pain. e.g. Hot or cold pack, electrotherapeutic modalities was given to the patients of both groups along with their specialized group treatment. The visual analog scale (VAS) and Modified Oswestry Low Back Pain Disability Questionnaire were used before treatment and after the third treatment session during the period of one to two weeks to measure outcomes. The independent samples T-test was used for data analysis. A P-value <0.05 was considered statistically significant Results: The results of this study illustrated that there is a significant difference between the two groups in clinical and therapeutic effect in the reduction of pain as the P-value is <0.05. While the results in the reduction of pain-related disability, measured by the Modified Oswestry Low Back Pain Disability Questionnaire, were not significant as P-value >0.05(P= 0.184). Conclusions: The study indicates that core stability exercises are more effective than Williams’ flexion exercises for the reduction of non-specific low back pain except for a reduction in pain-related disability.

Managing Nontraumatic Acute Back Pain

Low back pain

The efficacy of interventions for low back pain in nurses: A systematic review

IntroductionNeck and back pain afflicts millions of people. Magnetotherapy has shown to have anti-inflammatory effects that could act on pain generation, but the literature lacks provide a precise therapeutic protocol.MethodsA high-intensity electromagnetic field with a dedicated applicator was administered to 38 patients with low-back pain and 30 patients with neck pain. The device provides 60 mT and a frequency of 50 Hz for 30 minutes, the session was repeated 4 times.ResultsThe mean VAS of the low-back pain group decreased from 6.56 to 4.54, with a significant reduction of 30.8%. The mean VAS of the neck pain group decreased from 6.51 to 1.96, with a significant reduction of 69.9%.DiscussionThe treatment used showed good results in both groups of the patient, without side effects. The therapeutic protocol adopted is safe, provide rapid relief from the pain and is not time demanding. This treatment could represent an effective non-pharmacologic physical therapy option in the treatment of low-back pain and cervical pain.

ObjectiveTo investigate the cost-effectiveness of exercise therapy in the treatment of patients with non-specific neck pain and low back pain.DesignSystematic review of economic evaluations.Data sourcesThe search was performed in 5...