The treatment of low back pain from the dual vision of Chinese medicine and Thai medicine

Managing Nontraumatic Acute Back Pain

ObjectivesTo investigate the efficacy of non-surgical and non-interventional treatments for adults with low back pain compared with placebo.Eligibility criteriaRandomised controlled trials evaluating non-surgical and non-interventional treatments compared with placebo or...

The role of activity in the therapeutic management of back pain. Report of the International Paris Task Force on Back Pain.

The objective of this study was to systematically evaluate the application of Chinese medicine in the treatment of neck and low back pain. The goal was to assess the efficacy, analgesic effect, and safety of Chinese medicine using Cochrane system evaluation standards and conduct a meta-analysis to provide high-quality, evidence-based medical data for clinical practice decision-making. A comprehensive search was conducted in Chinese and English databases, including CBM, CNKI, Wanfang Data Knowledge Service Platform, VIP Chinese Science and Technology Periodical Database, Pubmed, Embase, and the Cochrane Library. The search encompassed randomized controlled trials on the use of Chinese medicine for pain treatment, with a time range from the establishment of each database to October 1, 2021. We have added the referred literature from the online databases for this research. Two researchers independently reviewed the literature, gathered data, and assessed the methodological quality of the included studies using the Cochrane Assistance Network risk of bias tool. Safety, reaction rate, and VAS pain score were of interest. To evaluate Chinese medicine's curative and analgesic benefits for pain illnesses, RevMan 5.4 and Stata 15.1 were used to analyze selected literature using forest plots, funnel plots, Egger and HarbORd linear regression plots, and star charts. Chinese medicine treated pain in 57 investigations. The analysis yielded (1) a curative effect: Chinese medicine outperformed Western medicine, with no publication bias. The sensitivity analysis matched the meta-analysis that has been performed in this work, and it shows that Chinese medicine treated low back pain better than Western medicine. (2) Analgesic effect: Chinese medicine outperformed Western medicine in analgesia, although the literature is limited for such a claim. Chinese medicine was also more analgesic than Western medicine. (3) Safety: No major side effects were reported in 20 investigations on Chinese medicine's safety. This study provides evidence that Chinese medicine can achieve better clinical efficacy and analgesic effects when comparing Chinese and Western medicine in the treatment of neck and low back pain. Furthermore, Chinese medicine demonstrated a favorable safety profile. However, further research is required to explore the use of Chinese medicine specifically for neck pain and to enhance the evidence base for clinical decision-making in pain management.

Low back pain

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

Low back pain

Objectives: To review the available evidence on the effectiveness of acupuncture in the treatment of low back pain. Data Sources:MEDLINE, National Guideline Clearinghouse, Guidelines Finder, Cochrane Library, DARE, Bandolier, UpToDate and Index of Portuguese Medical Magazines. Review Methods: Research using the MeSH terms acupuncture and low back pain and the DeCS terms acupuntura e dor lombar. The search was limited to articles published between January 2000 and May 2009 in english, portuguese and spanish. American Family Physicians Strength of Recommendation Taxonomy (SORT) was used to assess the level of evidence. Results: Two meta-analysis, six systematic reviews, three randomised controlled trials and three guidelines met inclusion criteria. Guidelines say that acupuncture might be helpful in the treatment of low back pain. Unspecific chronic low back pain: the meta-analysis, systematic reviews and randomised controlled trials demonstrated that acupuncture is more effective than notreatment and that the association of acupuncture with conventional treatment is more effective than isolated conventional treatment. The studies didnt demonstrate that acupuncture was more effective than placebo or conventional therapies. Acute low back pain: data are inconclusive. Conclusions: Acupuncture is effective in the treatment of unspecific chronic low back pain, isolated or in addition to other interventions (SORT A); it was not proved that acupuncture was superior to other interventions. In the treatment of acute low back pain, there was no evidence of effectiveness of acupuncture. It would be advisable to do high quality, long-term, controlled and randomised studies, addressing its cost-benefit.

Low back pain is defined as any pain that occurs between the last costal arch and the lower gluteal fold, and may have different intensities and durations, being considered chronic if it lasts for more than 12 weeks, becoming non-specific if its cause is not identified, compromising the quality of life of affected individuals. Currently, Strength Training (TF) has been included in the treatment of chronic non-specific low back pain, in order to improve the condition of people suffering from this condition. Thus, the objective of this research was to verify the impact of PT on the treatment of low back pain, highlighting the main aspects based on the inclusion of this practice in everyday life, showing the benefits arising from this method. For the present study, a review of scientific articles was carried out using the PubMed, Scielo and Google Scholar databases to complement information on low back pain and PD. Several evidences were found that positively contribute to the improvement of low back pain with the use of PT in pain conditions, increased functional capacity, improvement in activities of daily living (ADL), gain in muscular resistance, strength and hypertrophy, in addition to individuals showing themselves more active. It is concluded that TF proved to be effective in the treatment of non-specific chronic low back pain, improving its symptoms such as pain and disability, however, if applied by an unqualified professional and incorrectly, it can be harmful to health.

Low back pain

Back pain is the second leading cause of disability among American adults and is currently treated either with conservative therapy or interventional pain procedures. However, the question that remains is whether we, as physicians, have adequate therapeutic options to offer to the patients who suffer from chronic low back pain but fail both conservative therapy and interventional pain procedures before they consider surgical options such as discectomy, disc arthroplasty, or spinal fusion. The purpose of this article is to review the potential novel therapies that are on the horizon for the treatment of chronic low back pain. We discuss medications that are currently in use through different phases of clinical trials (I–III) for the treatment of low back pain. In this review, we discuss revisiting the concept of chemonucleolysis using chymopapain, as the first drug in an intradiscal injection to reduce herniated disc size, and newer intradiscal therapies, including collagenase, chondroitinase, matrix metalloproteinases, and ethanol gel. We also review an intravenous glial cell-derived neurotrophic growth factor called artemin, which may repair sensory nerves compressed by herniated discs. Another new drug in development for low back pain without radiculopathy is a subcutaneous monoclonal antibody acting as nerve growth factor called tanezumab. Finally, we discuss how platelet-rich plasma and stem cells are being studied for the treatment of low back pain. We believe that with these new therapeutic options, we can bridge the current gap between conservative/interventional procedures and surgeries in patients with chronic back pain.

Traditional Chinese and Thai medicine in a comparative perspective

Introduction The Pilates® method incorporates a number of the guidelines recommended for therapeutic exercises considered to be effective in the treatment of chronic lower back pain, such as the contraction of the transversus abdominis and multifidus muscles, associated with breathing, while taking into account the individual characteristics of patients. Objective To assess the effects of the Pilates® method on the treatment of lower back pain. Method This systematic review includes papers published from 2000 to 2010 in the BIREME, LILACS, MEDLINE and SciELO databases. The keywords used were spinal stabilization, Pilates®, and back pain and their equivalents in Portuguese. Results Imbalance among the trunk’s agonist-antagonist muscles and the ineffective activation of the transversus abdominis are risk factors for the onset of lower back pain that can be mitigated with the practice of Pilates®-based exercises. Conclusion The method has clinical effects similar to those obtained with traditional stabilization exercises and Back School exercises in the treatment of chronic lower back pain and are considered more satisfactory than conservative treatments.

BackgroundChronic low back pain is a common painful medical problem which has significant socioeconomic impact. Conventional pharmacological therapy usually associated with adverse effects. Mesotherapy is a minimally invasive technique done...

BackgroundMany methods have been used in to treat low back pain. In this study, we aimed to investigate the efficacy of dexketoprofen alone and in combination with methylprednisolone in the treatment of low back pain in the emergency department using the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI).MethodsThis prospective, randomized, single-blind study included 150 patients admitted to the emergency department of a university hospital. Patients with low back pain were divided in to two groups: those receiving intravenous dexketoprofen treatment (Group D) and those receiving dexketoprofen + methylprednisolone treatment (Group DM). The efficacy of the treatments received by the patients was evaluated with the VAS at minutes 0, 15, 30, and 60 and hour 48. Statistical evaluations were also undertaken on the ODI results evaluated at minute 0 and hour 48.ResultsThe VAS scores decreased in both groups at all follow-up evaluations performed throughout the treatment (p = 0.000). The mean VAS score evaluated 48 h after treatment was 1.69 ± 1.71 (Median:1) cm in Group DM and 4.13 ± 2.27 (Median:4) cm in Group D (p = 0.000). The decrease in the ODI score was greater in Group DM than in Group D (p = 0.000).ConclusionDexketoprofen showed analgesic efficacy in the treatment of non-traumatic low back pain and decreased disability. When combined with methylprednisolone, dexketoprofen treatment exhibit a greater analgesic effect and further reduced disability.Trial registrationCurrent Controlled Trials NCT06932367 (Retrospectively registered).Clinical trial numberNot applicable.