Background

Millions of people worldwide suffer from nonspecific low back pain (NSLBP), regardless of age or socioeconomic status. Although many therapeutic interventions are available for NSLBP, which are the most effective?

The study

This meta-analysis of randomized controlled trials assessed the effectiveness of interventions for acute (<6 weeks) and subacute (6–12 weeks) NSLBP. The primary outcomes were pain intensity and disability, and the secondary outcome was any occurrence of adverse events. In total, 46 studies assessing 8,765 participants were included.

The results

The following treatments significantly reduced pain, in order of efficacy (starting with the most efficacious):

  • Exercise
  • Heat wraps
  • Opioids
  • Manual therapy
  • NSAIDs (nonsteroidal anti-inflammatory drugs)

The following treatments significantly reduced disability, in order of efficacy:

  • Exercise
  • Heat wraps
  • Manual therapy
  • NSAIDS
  • Education
  • Muscle relaxants

There was no significant effect of paracetamol or acupuncture on either outcome.

Mild or moderate adverse events were reported for heat wraps, muscle relaxants, NSAIDs, opioids, paracetamol, steroids, and inert treatment. Adverse events occurred most often among patients taking opioids.

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This Study Summary was published on July 2, 2021.