Study 8: “Nonpharmacologic therapies for low back pain: a systematic review for an American College of Physicians clinical practice guidelines” Chou et al.
This systematic review investigated the effect of 9 different nonpharmacologic therapies for low back pain including exercise, tai chi, yoga, mindfulness-based stress reduction, psychological therapy, multidisciplinary rehabilitation, acupuncture, massage, and spinal manipulation. After a systematic search, 114 total trials were included small to moderate magnitude of effect on pain were found for exercise, tai chi, yoga, mindfulness-based stress reduction, progressive relaxation, electromyography biofeedback, operant therapy, cognitive-behavior therapy, multidisciplinary rehabilitation, acupuncture, and spinal manipulation. Similar effects were found for effect on improving function, however, the magnitude effect tended to be smaller for function compared to pain. The key takeaway from this large systematic review is that many nonpharmacologic therapies can be helpful for treating low back pain. The evidence continues to support the use of nonpharmacologic therapies as first-line treatment for low back pain.
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