Treatment Of Low Back Pain Research Articles

Wearable low back trainer combined with massage in the treatment of chronic nonspecific low back pain

<p><strong>Objective:</strong> To observe the clinical effect of wearable low back trainer combined with massage in the treatment of chronic non-specific low back pain. <strong>Methods:</strong> A total of 56 chronic nonspecific low back pain patients were randomly assigned to three groups. The ob group (n=19) was treated with wearable device treatments based on massage for two weeks, once a day, eight minutes each time, five times a week, while the control group (n=19) received massage only for two weeks, once a day, 20 minutes each time, and the blank group (n=18) rest only with closely observation. The therapeutic effect of three groups were evaluated by VAS and ODI scores before the treatment, one week after treatment and two weeks after treatment respectively. <strong>Results:</strong> There was no significant difference in the VAS score between the observation group and the control group before treatment (P>0.05) while the VAS score difference between the three groups after one week and two weeks of treatment were statistically significant (P<0.05). The VAS scores of the observation group and the control group showed a downward trend with time. After 2 weeks of treatment, the VAS value of the observation group decreased significantly more than the control group, and the difference was statistically significant (P<0.05). The decrease of VAS value in the group was significantly greater than that in the blank group, and the difference was statistically significant (P<0.05). There was no significant difference in the ODI score between the observation group and the control group before treatment and after 1 week of treatment (P>0.05). However, there was a statistically significant difference in the ODI score between the three groups after 2 weeks of treatment (P<0.05). The changing trends of ODI values in the three groups were different and both the observation group and the control group showed a downward trend. After two weeks of treatment, the ODI values of the observation group decreased significantly more than the control group with statistically significant differences (P<0.05). However, the ODI value of the blank group decreased after 1 week of treatment and increased again after two weeks of treatment. <strong>Conclusion: </strong>The use of the wearable low back trainer combined with massage therapy has a better therapeutic effect on chronic non-specific low back pain and can relieve pain more effectively than just simple massage therapy alone.</p>

Trunk Alignment in Physically Active Young Males with Low Back Pain.

Background: Systematic physical activity has become an essential part of the guidelines for the prevention and treatment of low back pain (LBP). The aim of this study was to assess differences in trunk alignment parameters with regard to the level of physical activity in groups of individuals with and without LBP. Methods: 43 participants with LBP and 37 healthy persons were recruited. Participants were divided into two subgroups: (1) students with a moderate level of physical activity (MPA); (2) students with a high level of physical activity (HPA). An original questionnaire was used to assess the prevalence of LBP. The spinal posture was measured using the Formetric 4D rasterstereographic system. Results: There were no significant differences between groups for any of the parameters assessed: trunk imbalance, trunk inclination, trunk torsion, pelvic tilt, pelvic inclination, pelvic torsion, kyphotic angle and lordotic angle. Conclusions: There are no differences in trunk alignment parameters in the sagittal, frontal and transversal planes between physically active males with and without LBP. Therefore, it can be assumed that physical activity may reduce the risk of the deterioration of trunk alignment in males with LBP younger than 25 years.

Editorial

<p class="Text">As a technology of huge convenience, wearable technology is penetrating into all industries in our lives. One of our editor board members Prof. Guozhi Huang offered an article <em>Wearable low back trainer combined with massage in the treatment of chronic nonspecific low back pain</em><em>.</em> In this issue, we will also see application of wearable technology in other industries such as oil and gas field and monitoring therapy.</p><p class="Text"> </p><p class="Text"> </p><p align="right">Managing Editor</p><p align="right">Dr. Yina Xu</p>

The Effectiveness of Intraosseous Basivertebral Nerve Radiofrequency Ablation for the Treatment of Vertebrogenic Low Back Pain: An Updated Systematic Review with Single-Arm Meta-analysis.

ObjectiveTo provide an estimate of the effectiveness of basivertebral nerve (BVN) radiofrequency ablation (RFA) to treat vertebrogenic low back pain (LBP).DesignSystematic review with single-arm meta-analysis.PopulationPersons ≥18 years of age with chronic LBP associated with type 1 or 2 Modic changes.InterventionIntraosseous BVN RFA.ComparisonSham, placebo procedure, active standard care treatment, or none.OutcomesThe proportion of patients treated with BVN RFA who reported ≥50% pain score improvement on a visual analog scale or numeric rating scale. The main secondary outcome was ≥15-point improvement in Oswestry Disability Index score.MethodsThree reviewers independently assessed articles published before December 6, 2021, in MEDLINE and Embase. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) framework was used to evaluate the overall quality of evidence.ResultsOf the 856 unique records screened, 12 publications met the inclusion criteria, representing six unique study populations, with 414 participants allocated to receive BVN RFA. Single-arm meta-analysis showed a success rate of 65% (95% confidence interval [CI] 51–78%) and 64% (95% CI 43–82%) for ≥50% pain relief at 6 and 12 months, respectively. Rates of ≥15-point Oswestry Disability Index score improvement were 75% (95% CI 63–86%) and 75% (95% CI 63–85%) at 6 and 12 months, respectively.ConclusionAccording to GRADE, there is moderate-quality evidence that BVN RFA effectively reduces pain and disability in most patients with vertebrogenic LBP. Further high-quality studies will likely improve our understanding of the effectiveness of this procedure.

Physiotherapists have some hesitations and unmet needs regarding delivery of exercise programs for low back pain prevention in adults: A qualitative interview study

BackgroundAlthough there is some qualitative research on physiotherapists’ experiences of delivering low back pain treatment, we do not know the extent that these findings apply to low back pain prevention. ObjectiveTo explore physiotherapists’ understanding, attitudes and experiences related to delivering low back pain prevention programs. DesignQualitative interview study. MethodInterviews from 25 Australian physiotherapists (56% female; 44% male) were analysed using framework thematic analysis. ResultsTheme 1 explored physiotherapists' hesitancy about ‘low back pain prevention,’ raising concerns this term might inadvertently entrench unhelpful beliefs. They preferred language about minimising the risk and impact of recurrences, and promoting an active lifestyle. Theme 2 emphasised that as pain receded, engaging patients could be challenging. Some discussed that person-centred care and individualised programs helped overcome this challenge. Several wanted more training in counselling skills, and more consistent external messaging about low back pain prevention. Theme 3 highlighted uncertainty about delivering high-value prevention care. Some perceived the programs as potentially placing unnecessary financial burden on some patients. Many physiotherapists were uncertain about how to support patients when they weren't in pain (i.e., remission) and wanted training in tailored exercise prescription. ConclusionsMany of the physiotherapists had some hesitations and unmet needs regarding delivery of exercise programs for secondary prevention of low back pain. Clinicians may find it useful to ask patients directly about their interest in prevention programs and work with interested patients to develop tailored, progressive programs that continue to be motivating, even during periods when there is no pain.

Effects of neural mobilization in the treatment of chronic low back pain: a systematic review

Introduction: Low back pain appears in approximately two thirds of the population at some point in life and when it exceeds more than 12 weeks, it evolves to chronic low back pain. Chronic low back pain is considered one of the most common causes of disability and absence from work. A therapeutic technique that can be used as a treatment for chronic low back pain is neural mobilization, capable of restoring compromised neurological structures, restoring movement by improving the elasticity of neural tissue and adjacent tissues. Objective: To verify the effects of neural mobilization in patients with chronic low back pain. Material and methods: All articles were carefully evaluated in order to obtain concrete and reliable information. The databases used were Google Scholar, Scielo, Medline and PubMed due to the methodological quality and articles in the area of interest. The keywords “low back pain”, “chronic low back pain”, “neural mobilization” and “physiotherapeutic intervention” were combined in the most diverse possibilities, in English and Spanish translations. Results: 86 articles were found, nine of which were included in this review. They had a score ≥ 5 on the PEDro Scale, which methodologically qualifies the articles. After analyzing the results obtained through the selected articles, all the data collected, as well as their respective results, were described in a table that contains data from the articles. Conclusions: Neural mobilization reduces pain and improves the extensibility of tissues, causing a reduction in painful sensation and increased flexibility. Therefore, it is necessary to continue research in order to verify new results obtained through this type of intervention.

A feasibility study on yoga’s mechanism of action for chronic low back pain: psychological and neurophysiological changes, including global gene expression and DNA methylation, following a yoga intervention for chronic low back pain

IntroductionYoga has been shown to reduce pain and improve function in populations with chronic low back pain (cLBP), yet the underlying molecular mechanisms remain elusive. This study examined the feasibility and acceptability of a yoga research protocol, including recruitment, retention, and data collection, and investigated the preliminary effects of yoga on psychological and neurophysiological functions, including gene expression and DNA methylation profiles, in participants with cLBP.MethodsA one-arm trial was conducted with 11 participants with cLBP who enrolled in a 12-week yoga intervention. Data on subjective pain characteristics, quantitative sensory testing, and blood for analysis of differentially expressed genes and CpG methylation was collected prior to the start of the intervention and at study completion.ResultsBased on pre-determined feasibility and acceptability criteria, the yoga intervention was found to be feasible and highly acceptable to participants. There was a reduction in pain severity, interference, and mechanical pain sensitivity post-yoga and an increase in emotion regulation and self-efficacy. No adverse reactions were reported. Differential expression analysis demonstrated that the yoga intervention induced increased expression of antisense genes, some of which serve as antisense to known pain genes. In addition, there were 33 differentially hypomethylated positions after yoga (log2 fold change ≥ 1), with enrichment of genes involved in NIK/NF-kB signaling, a major pathway that modulates immune function and inflammation.Discussion/conclusionsThe study supports the feasibility and acceptability of the proposed protocol to test a specific mechanism of action for yoga in individuals with cLBP. These results also support the notion that yoga may operate through our identified psychological and neurophysiologic pathways to influence reduced pain severity and interference.

Use and Cost of Low-Value Health Services Delivered or Paid for by the Veterans Health Administration

Within the Veterans Health Administration (VA), the use and cost of low-value services delivered by VA facilities or increasingly by VA Community Care (VACC) programs have not been comprehensively quantified. To quantify veterans' overall use and cost of low-value services, including VA-delivered care and VA-purchased community care. This cross-sectional study assessed a national population of VA-enrolled veterans. Data on enrollment, sociodemographic characteristics, comorbidities, and health care services delivered by VA facilities or paid for by the VA through VACC programs were compiled for fiscal year 2018 from the VA Corporate Data Warehouse. Data analysis was conducted from April 2020 to January 2022. VA administrative data were applied using an established low-value service metric to quantify the use of 29 potentially low-value tests and procedures delivered in VA facilities and by VACC programs across 6 domains: cancer screening, diagnostic and preventive testing, preoperative testing, imaging, cardiovascular testing and procedures, and other procedures. Sensitive and specific criteria were used to determine the low-value service counts per 100 veterans overall, by domain, and by individual service; count and percentage of each low-value service delivered by each setting; and estimated cost of each service. Among 5.2 million enrolled veterans, the mean (SD) age was 62.5 (16.0) years, 91.7% were male, 68.0% were non-Hispanic White, and 32.3% received any service through VACC. By specific criteria, 19.6 low-value services per 100 veterans were delivered in VA facilities or by VACC programs, involving 13.6% of veterans at a total cost of $205.8 million. Overall, the most frequently delivered low-value service was prostate-specific antigen testing for men aged 75 years or older (5.9 per 100 veterans); this was also the service with the greatest proportion delivered by VA facilities (98.9%). The costliest low-value services were spinal injections for low back pain ($43.9 million; 21.4% of low-value care spending) and percutaneous coronary intervention for stable coronary disease ($36.8 million; 17.9% of spending). This cross-sectional study found that among veterans enrolled in the VA, more than 1 in 10 have received a low-value service from VA facilities or VACC programs, with approximately $200 million in associated costs. Such information on the use and costs of low-value services are essential to guide the VA's efforts to reduce delivery and spending on such care.

Modified prolotherapy by 5% dextrose: Two years experiences of a traditional and complementary medicine practice center in Turkey.

Prolotherapy (PrT) is an increasingly popular regenerative injection treatment for the management of musculoskeletal injuries. The diagnostic injection is a method for selecting suitable patients to apply PrT using subcutaneous 5% dextrose solution. The study aims to assess the PrT usage and modifications in the treatment of chronic low back pain and lumbar disc herniation and to define diagnostic injection procedure for PrT. Two thousand three hundred and eighty-two patients with low back pain or lumbar disc herniation were evaluated at the Traditional and Complementary Medicine Practice Center in Ankara, Turkey. Six hundred fifty-four patients were included in the study. Diagnostic injections were performed on all patients who were thought to be eligible candidates for PrT indications. A 4-or-6 week interval was allowed between treatment sessions. Xix hundred and fifty-four patient treatments were completed. The Visual Analogue Scale (VAS) scores decreased to 5.1 ± 1.4 while 7.2 ± 1.1 before the diagnostic injection (p< 000.1). The VAS scores decreased from 7.2 ± 1.1 before the treatment to 0.9 ± 0.9 after 52 weeks of the treatment (p< 000.1). Thirty-four patients' treatments resulted in poor clinical results (5.2%), and 620 of the patients' pain improved (94.8%). PrT can be regarded as a safe way of providing a meaningful improvement in pain and musculoskeletal function compared to the initial status. Diagnostic injection is an easy way to eliminate patients and may become a favorite treatment modality. 5% dextrose is a more simple and painless solution for PrT and also has a high success.

Acupuncture as complementary treatment for lower back pain

Abstract&#x0D; Introduction: Lower back pain is one of the most common disorders in the world. Acupuncture is one the methods of treatment, but its efficiency is still researched.&#x0D; Aim of the study: To verify the effectiveness of acupuncture on low back pain.&#x0D; Material and Methods: Search of the PubMed database using the following keywords: acupuncture, lower back pain. Only full-length articles were taken into consideration.&#x0D; Results: The studies show that acupuncture is effective in the treatment of chronic low back pain and is not inferior to the usual care. However its efficiency in treatment of acute low back pain is not satisfactory and patients still require additional pharmacotherapy.&#x0D; Conclusion: Acupuncture is efficient in the treatment of chronic low back pain, however more research is needed on its efficiency in treatment of acute low back pain.&#x0D; &#x0D; Keywords: acupuncture, lower back pain

OTC Analgesics vs Opioids for Pain Management.

The use of opioids in acute pain may be appropriate in some situations, but there are opportunities to reduce exposure to opioids with equally effective monotherapy and combination therapy over-thecounter (OTC) medications. There are a number of OTC analgesics that are readily accessible and costeffective options to treat pain. The American College of Rheumatology Osteoarthritis Guideline "strongly" recommends the use of topical nonsteroidal antiinflammatory drugs (NSAIDs) and oral NSAIDs to treat arthritis pain, and it conditionally recommends against the use of opioids (other than tramadol). The American Headache Society suggests that OTC NSAIDs and combination medications such as acetaminophen, aspirin, and caffeine are Level A recommendations for reducing migraine pain and other symptoms. Nonopioid OTC analgesics, such as NSAIDs and the NSAID/acetaminophen combination, are safe and effective firstline options for managing acute dental pain according to the American Dental Association. The American College of Physicians supports the use of NSAIDs as first-line therapy for the treatment of low back pain.

Influence of comorbidities on pain intensity in patients with chronic low back pain

ObjectivesChronic pain is a complex process that can vary depending on factors such as time evolution, mood, or even previous experiences. Our objective is to describe patient’s characteristics from those who were referred with a diagnosis of low back pain in their first Pain Unit (PU) visit, and identify those factors that may interfere with their pain perception. MethodsInferential analysis was carried out from data recorded in the PU database of the Hospital de la Santa Creu y Sant Pau in Barcelona, from November 2012 to November 2018. The average pain intensity during the last 24 hours (EVN24) was quantified using data from the BPI (Brief Pain Inventory) questionnaire. Using multiple linear regression, the independent predictive factors related to pain intensity (EVN24) were assessed. ResultsMood disorders (Degree of depresión acording HAD_D level) was the variable with the highest impact in pain perception. Using binary logistic regression for multivariate analysis, a model of variables related to pain intensity (EVN24) was obtained (R = 0.354, P < 0.001). ConclusionsThe specialized treatment of low back pain in PUs must take into account the patient's profile and especially the affective disorders and associated comorbidities since they predict a greater intensity of pain. Consequently, the associated comorbidity not only affects the greater intensity of pain, but the physical characteristics that accompany the patient throughout the process can influence or even compromise treatment.

Non-surgical therapy for the treatment of chronic low back pain in patients with Modic changes: A systematic review of the literature

BackgroundIn absence of uniform therapeutic recommendations, knowledge of the available treatment options for Modic changes (MCs) patients and their safety and effectiveness would be crucial and significant for clinicians and such patients. ObjectivesThe aim of this study was to provide a systematic review of available studies on non-surgical treatments of MCs. MethodsWe performed a systematic review of multiple electronic databases including PubMed, Web of Science, Embase, Cochrane Library, and China National Knowledge Infrastructure for the period until 31st August 2021 to search for studies on non-surgical treatments for MCs in accordance with the guidance of the Cochrane Handbook. Potential studies were screened by their titles and abstracts. The methodological quality of the included studies was independently evaluated by two authors. Final recommendations for the included interventions were developed based on grades of recommendations. The narrative format was adopted to synthesize the findings of the present work. ResultsFifth studies involving a total of 1147 patients were identified for this systematic review. The results of this review demonstrated that spinal manipulation has been suggested as an alternative option for patients with MCs. However, there was insufficient evidence to support that patients with MCs can benefit from the medication and wearing the rigid lumbar brace. Moreover, the rationale and safety for the use of antibiotics in such patients remain highly controversial. Low evidence revealed that exercise therapy might decrease pain intensity only for special subgroups of MCs patients. ConclusionsThere is not yet enough evidence to suggest that non-surgical treatments are useful for patients with MCs. Further high-quality, multicenter trials are required to validate the effectiveness of these non-surgical treatments.

Decreased Risk of Low Back Pain During Pregnancy Associated With the Use of Orthopedic Manual Therapy: A Nested Case-Control Study.

BackgroundRecent evidence suggests that the use of orthopedic manual therapy (OMT) may lessen the subsequent risk of low back pain (LBP), but this association has not been examined among pregnant women who are at higher risk of LBP. This study aims to determine whether the addition of OMT to conventional LBP treatment before pregnancy could decrease the subsequent risk of LBP during pregnancy.MethodsFrom Taiwan's National Health Insurance Research Database, we identified 68,960 women, 20–55 years of age, with first pregnancy between 2001 and 2012. We then performed a nested case-control study in which 3,846 women with newly diagnosed LBP were matched to 3,846 controls according to age and cohort entry year. Multivariate conditional logistic regression was employed to estimate the association between OMT use before pregnancy and LBP during pregnancy.ResultsOMT users had a lower risk of LBP than did non-users, with an adjusted OR of 0.86 (95% CI, 0.78–0.93). Subgroup analysis showed that women with high intensity use of OMT treatment prior to pregnancy reported the lowest level of LBP during pregnancy by nearly 30%.ConclusionThe pre-pregnancy use of OMT treatment significantly decreased LBP risk during pregnancy, especially with high-intensity use. Thus, clinicians may consider recommending OMT for pregnant women to avoid possible obstetric complications during the pregnancy.

Effect of Central Stability and Dynamic Neuromuscular Stabilization Exercises on Pain, Flexibility, Balance, Muscle Endurance and Quality of Life in Men With Nonspecific Chronic Low Back Pain

Background: Study on the effectiveness of new methods of low back pain treatment is very important due to its high prevalence. There is no consensus on the most effective treatment for low back pain, despite the existence of different treatments options. Objective: This study aims to assess the effect of 8 weeks of dynamic neuromuscular stabilization (DNS) and core stability (CS) exercises on pain, hamstring flexibility, balance, abdominal muscle strength, and quality of life (QoL) in men with chronic low back pain. Methods: Participants were 20 men with non-specific low back pain, randomly divided into two groups of DNS (Age=47.8±9.82 years, BMI=25.8±2.9 kg/m2) and CS (Age=42.4±11.8 years, BMI=28.1±13.1 kg/m2). Subjects performed exercises for 8 weeks. Before and after exercises, their pain, hamstring flexibility, static and dynamic balances, abdominal muscle strength, and QoL were assessed. For data analysis, the paired t-test and analysis of covariance were used, considering a significance level of P&lt;0.05. Results: Both training methods improved pain, abdominal muscle strength and static balance. The CS exercise significantly improved hamstring muscle flexibility, and DNS exercise significantly improved QoL. The comparison between the two methods showed no significant difference in any study variables. Conclusion: Both CS and DNS exercises can be used in designing the interventions for patients with chronic low back pain.

The Top 100 Most-Cited Publications in Musculoskeletal Rehabilitation: A Bibliometric Analysis.

Musculoskeletal conditions are the leading contributor to global healthcare expenditure and with an increase in ageing global population, this number is projected to rise further. To determine the top 100 most-cited studies in field of musculoskeletal rehabilitation and to conduct their bibliometric analysis. Scopus was used for identification of studies, published in the field of musculoskeletal rehabilitation over last five decades. Literature search was conducted in February 2021 with final Boolean search phrases being: [(musculoskeletal) and (rehabilitation) and (musculoskeletal rehabilitation)]. In addition to number of citations, data was also collected for other variables such as title of study, topic of discussion, subdivisions of clinical and applied science involved in conduction of study, study design, journal and its impact factor, year of publication, and country where study was conducted. The top 100 most-cited articles in musculoskeletal rehabilitation over the last 50years were published between 1973 and 2015. Total number of citations was 24,366, with an average of 243.66 citations per paper. Highest citation was reported by apaper on treatment of low back pain by Waddell G. The decade of 2000-2009 contributed maximum articles with highest number of publications from journal "Archives of Physical Medicine and Rehabilitation". Most of the publications were from United States and most common topic to feature among these articles was "Strength training". This study identifies the top 100 most-cited articles in musculoskeletal rehabilitation and provides insight into its historical trends while serving as a guide for future research.

Digitally Delivered Exercise and Education Treatment Program for Low Back Pain: Longitudinal Observational Cohort Study.

BackgroundExercise and education is recommended as first-line treatment by evidence-based, international guidelines for low back pain (LBP). Despite consensus regarding the treatment, there is a gap between guidelines and what is offered to patients. Digital LBP treatments are an emerging way of delivering first-line treatment.ObjectiveThe aim of this study is to evaluate outcomes after participation in a 3-month digitally delivered treatment program for individuals with subacute or chronic LBP.MethodsWe analyzed data from 2593 consecutively recruited participants in a digitally delivered treatment program, available via the national health care system in Sweden. The program consists of video-instructed and progressive adaptable exercises, education through text lessons, and a chat and video function connecting participants with a personal physiotherapist. The primary outcome was mean change and proportion reaching a minimal clinically important change (MCIC) for LBP (2 points or 30% decrease) assessed with the numerical rating scale (average pain during the past week, discrete boxes, 0-10, best to worst). Secondary outcomes were mean change and proportion reaching MCIC (10 points or 30%) in disability, assessed with the Oswestry Disability Index (ODI; 0-100, best to worst) and a question on patient acceptable symptom state (PASS).ResultsThe mean participant age was 63 years, 73.85% (1915/2593) were female, 54.72% (1419/2593) had higher education, 50.56% (1311/2593) were retired, and the mean BMI was 26.5 kg/m2. Participants completed on average 84% of the prescribed exercises and lessons, with an adherence of ≥80% in 69.26% (1796/2593) and ≥90% in 50.13% (1300/2593) of the participants. Mean reduction in pain from baseline to 3 months was 1.7 (95% CI –1.8 to –1.6), corresponding to a 35% relative change. MCIC was reached by 58.50% (1517/2593) of participants. ODI decreased 4 points (95% CI –4.5 to –3.7), and 36.48% (946/2593) reached an MCIC. A change from no to yes in PASS was seen in 30.35% (787/2593) of participants. Multivariable analysis showed positive associations between reaching an MCIC in pain and high baseline pain (odds ratio [OR] 1.9, 95% CI 1.6-2.1), adherence (OR 1.5, 95% CI 1.3-1.8), and motivation (OR 1.2, 95% CI 1.0-1.5), while we found negative associations for wish for surgery (OR 0.6, 95% CI 0.5-0.9) and pain in other joints (OR 0.9, 95% CI 0.7-0.9). We found no associations between sociodemographic characteristics and pain reduction.ConclusionsParticipants in this digitally delivered treatment for LBP had reduced pain at 3-month follow-up, and 58.50% (1517/2593) reported an MCIC in pain. Our findings suggest that digital treatment programs can reduce pain at clinically important levels for people with high adherence to treatment but that those with such severe LBP problems that they wish to undergo surgery may benefit from additional support.Trial RegistrationClinicalTrials.gov NCT05226156; https://clinicaltrials.gov/ct2/show/NCT05226156

Reply to Kudus, A.L. Comment on "Brandl et al. Immediate Effects of Myofascial Release on the Thoracolumbar Fascia and Osteopathic Treatment for Acute Low Back Pain on Spine Shape Parameters: A Randomized, Placebo-Controlled Trial. Life 2021, 11, 845".

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Association between chiropractic spinal manipulative therapy and benzodiazepine prescription in patients with radicular low back pain: a retrospective cohort study using real-world data from the USA

ObjectivesAlthough chiropractic spinal manipulative therapy (CSMT) and prescription benzodiazepines are common treatments for radicular low back pain (rLBP), no research has examined the relationship between these interventions. We hypothesise that...

Patients’ and physiotherapists’ perspectives on implementing a tailored stratified treatment approach for low back pain in Nigeria: a qualitative study

BackgroundStratified care has the potential to be efficient in addressing the physical and psychosocial components of low back pain (LBP) and optimise treatment outcomes essential in low-income countries. This study...